Can Some Treatment For Mental Health Problems Make Issues Worse?

Peanuts are a great source of protein, anti oxidants, and have been shown to be beneficial to heart health. When I eat a peanut, my heart throws a little fiesta in celebration and uses every ounce of peanut to make itself extra awesome. When my imaginary friend Jimmy eats a peanut however, he explodes and turns into a bucket of water (Jimmy has a very severe imaginary peanut allergy. Don’t worry though, I gave him an imaginary unicorn to ride on as compensation for his unfortunate condition). 

Clearly then, sometimes, things that are supposed to be good for us and that are supposed to be beneficial to our health don’t work for some people, and the same can be said of mental health treatment. 

Now before I get carried away I would like to express that I am VERY grateful for all of the mental health treatment I have received over the years, even the things that haven’t worked out, because they have taught me what kind of things do and don’t work for me. I know I am very fortunate to have had so much and such a variety of support, as there are all too many people out there who don’t get any treatment at all and that is heartbreaking. Anyone suffering with a mental health condition should be able to access treatment, end of discussion, so I am not saying “screw all of you people who have never had any help, I have had some unhelpful help so pity me”. 

Instead, I think it is important to look at some aspects of mental health treatment that can maybe cause more problems than they solve so that we can improve that treatment and make it better in the future. It is all well and good to say “all treatment is good treatment and you should just take it no matter what” but if we did that we would never move further in the ways people with mental health problems are supported and increase the benefits that support can bring.

Hundreds of years ago, people with what we might potentially diagnose with mental health problems, were seen to have evil spirits lurking inside of them and were treated by having a drill shoved through their skull to let the spirits out. If nobody had ever stopped to think “hey, maybe this bashing people about the head isn’t very helpful after all”, we might still be doing that today (which would make my weekly trip to my psychologist even more terrifying), so although I don’t think anything around today is as detrimental as head drilling, I have personally found some treatments to be quite problematic. In this post I therefore I want to be seen as looking at the peanuts and trying to keep all the goodness in whilst getting rid of all that stuff that turns imaginary people like poor Jimmy into imaginary buckets, rather than as throwing all the peanuts into the bin and declaring them all to be useless. 

I am sure there are a lot of people out there who can attest to treatments that have been more detrimental than helpful in the sense that a lot of times, group treatments and inpatient settings can be rather triggering. I have known many people who have picked up behaviours from other people they have met in hospital, but I think this is less a problem of the style of treatment and more a problem with the competitive/comparative nature of certain illnesses themselves. It would be unrealistic to say that everyone who is ever hospitalised should be kept in a separate room away from other potentially triggering patients because that isn’t real life, there are always going to be people who trigger you no matter where you are, and the key is to learn to deal with and manage that. 

When it comes to problems with treatment however, an important example for me in terms of an actual treatment style that made things worse for me, was a certain inpatient unit I was in for my eating disorder, and their extreme “this is the most important thing ever” focus on weight. 

Before I went to that unit, I did not weigh myself, nor did I care about the number of kilos on the scale or what my BMI was. 

My eating disorder was all about how I saw myself in the mirror and how I felt inside. Some days I would struggle more because I “felt” and saw myself as extra disgusting, whereas other days I would do better because I maybe didn’t feel as terrible about myself. 

If I had been weighing myself during those times, there probably wouldn’t have been much difference between the numbers shown on the scales on the days that I “felt massive” compared to the days I “felt not as bad”, like I said, it was all subjective and all internally measured by my emotions as apposed to any little plastic square I could stand on that would then flash numbers at me. Ok, I counted calories obsessively, but when it came to weights, numbers were irrelevant to me, and if you had told me what I weighed it wouldn’t have had any meaning to me. 

During my first inpatient admission for my eating disorder however, all of that changed, and it is since that admission that my eating disorder has progressed to the point where my it is still concerned with how I feel but also obsessed with the number on the scales and the great significance “what that means” (spoiler alert: it means very little nothing at all in terms of a person’s self worth or value on this planet. That kind of thing is instead measured by how lovely you are to people and whether or not you are one of those cheeky people who puts an empty carton of milk back in the fridge just to destroy someone’s morning hopes of a bowl of Coco Pops. THE MILK CANNOT TURN CHOCOLATEY IF YOU DON’T LEAVE ME ANY MILK).

I understand that in eating disorder treatment it is important to be aware of weight to a certain degree for various reasons (not that the weight of someone with an eating disorder will tell you how ill they are or how physically at risk they are of serious complications), but in this unit, weight meant EVERYTHING and every number on the BMI scale had a significant consequence to it. It would have been one thing if there was a rough weight band stage thing to use as a guide, but instead of that each number specifically told you what you were allowed or not allowed to do. 

Some I could vaguely understand. There was a weight at which you were allowed to do yoga for example, a weight at which you could go bowling, and a weight at which you were given permission to walk around the grounds. It is the more arbitrary number obsessions that I think should have been focused more on the individual and their struggles/progress, rather than simply basing it on silly numbers. For example there was a weight under which you were not allowed to pick your own food at lunch and instead had to keep your fingers crossed that the nurse wouldn’t pick the one option that you genuinely hated for reasons outside of your eating disorder, a weight at which you were allowed to pour your own milk into your cereal, even a weight you had to reach to earn the right to spread butter and jam on your own toast. 

Again I get the importance of this, very early on in treatment people may be unable to spread an acceptable amount of toppings on their toast or decide what option to chose at lunch so that extra support may be warranted, but who is at what stage should not have been decided by weight alone. 

For example what if someone who was severely unwell came onto the unit above the weight of toast spreading privilege. Was it fair to leave them wrestling with the marmalade on day one just because their weight was a few digits out? And what about people who mentally progressed very quickly and although they came in at low weights were able to manage marmalade responsibility before their weight reached acceptable levels. I knew of several people whose bodies struggled to gain weight no matter what they ate and they got frustrated in feeling mentally held back by not being allowed to spread their own toast or pick from the options at lunch themselves, skills that would have been beneficial for them to practice to carry out responsibly. 

Obviously if they had started demanding dry toast and a celery stick for meals it might not have been the best idea, but neither is holding people back or pushing them forward simply because of a number that doesn’t measure the mental part of the mental illness. 

Like I said, before that admission, weight was not a concern, but ever since then, what I weigh has always been significant, and I still think of my personal weight as a measure of how well I am to some degree, regardless of the mental struggle. Even now I still see those weights as the “well enough to spread jam” weight which allows my head to use these opportunities when I am at these weights to convince me that I am “ok now” (clearly when one has the ability to spread jam on one’s own toast it means that a person is fully recovered and needs no other progress to enable a healthy life…YAY EATING DISORDER LOGIC.) It just seems a bit confusing to me how so many therapists and eating disorder services over the years will tell you to “ignore the number” and tell you that “it doesn’t matter”…yet then go on to measure your level of wellness by that number and dictate your rights accordingly, showing that it actually matters and means a lot…contradictory much? 

The second example of treatment that I personally think caused more problems than it solved was my first admission to hospital when I was about 11. Admittedly I needed to be there, my OCD behaviours were controlling my life, everything was completely out of hand and someone needed to step in, but remember I was a scared 11 year old suddenly waking up in this mental hospital and  living away from home for the first time. I needed treatment yes, but primarily, I needed mental support, and that wasn’t what I got.  

My shower and soap rituals were instead physically controlled by means such as locking me out of the bathroom and stealing my soap. Now, exposure therapy for things like OCD is a very valid method of treatment, you are scared of something, you expose yourself to it, people help you through that exposure with support and you keep practicing until it isn’t scary anymore. 

Problem was, I had nobody to help me work through that exposure, all treatment was physical and ironically there was no mental support whatsoever despite the fact it was a mental hospital. 

Therefore, instead of working through my problems, I was just traumatised for weeks and left to struggle alone in absolute terror, so naturally, when I went home, I was not a fan of psychologists and would refuse further treatment. Had they worked with rather than “on” me, I would have trusted them and would have seen them as people I could work with to get through my problems, but in my 11 year old brain that experience taught me that therapists were nasty people who take you away from your parents, lock your bathroom, leave you to suffer alone and then send you home with all the mental pain you had before plus a little bit of bonus anxiety. Consequently, there were several years where I refused to see therapists and would lock myself in our home bathroom when they came to visit, refuse to go to clinics, or “forget” to leave lessons when they came to visit at school for sessions (that’s right…I hated therapy so much I voluntarily stayed in Maths lessons that I was allowed to get out of…MATHS!)

It has taken a long time for me to get to the point where I can trust therapists again, actually talk to them, see them as humans rather than soap stealing villains, and still every mention of exposure therapy sends me bananas because my first bad experience of it has not left me excited to give it another go… 

So, can certain kinds of mental health treatments actually make a person worse? Well, yes, and though I think it is important to try new things and approaches, it is equally important not to label all treatment as helpful and to be able to critique the bits that maybe aren’t as helpful and could use a bit of a rethink so that we can improve them, keep the good and edit out the bad, or else we would still be in the time of drilling people in the head, and nobody wants that. By all means use a drill to put up a nice painting or build a table, but when it comes to my noggin, I would rather you kept all power tools at a safe distance. 

Take care everyone x 

Bucket

5 Tips For When Mental Health Carers Go Away On Holiday

If you struggle with mental health problems, there is a high chance that you have some sort of carer in your life, someone who helps you get through the day, someone who supports you through the particularly bad times and stays with you when you need. Indeed, carers for people with mental health problems can feel like people you couldn’t live without because they are so integral to your daily survival and that is how I feel about my mental health carers, my parents, although mainly my mum, who had to give up work partly to look after me because having a real job and the job of looking after a total lunatic was far too much for one poor woman to manage.
So if carers are so vital for life, what happens when carers do the terrifying thing and go away for a while, perhaps on a much deserved and needed holiday? What do you do then? What do you do when your person isn’t there for a period of time? Well, to be perfectly honest if it were me, I would go into a total panic and start crying hysterically which is funnily enough how I have been reacting in this situation for as of today both of my parents are heading off to Cyprus on holiday for a week, a week in which I am going to have to find different ways to manage my survival.

So today, seeing as it is so scary to have carers go away and seeing as I am dealing with this myself, I thought I would talk about how to manage, for I think it is an occasion that requires some kind of plan and is not very much like eyeliner in the sense that it is something one can merely “wing”…

Tip 1 – Make a list: Over the course of any one day, a carer can perform a multitude of tasks and when we try to think about all these tasks all at once and how we will manage them alone, it can become overwhelming. For this reason I think the first part to the plan of action is to make a list of all the things your carer does for you or helps you with every day or every week so that you can tackle each hurdle individually and set up a solution for every single one rather than throwing yourself in at the deep end with the overwhelming task of simply “managing everything” by oneself. If you are faced with a week without your carer the prospect can seem daunting, too many hours and too many tasks to truly comprehend but if you break it down into more manageable chunks it becomes less intimidating and also allows you to anticipate what exactly is going to be difficult when left to your own devices. For example, before my parents were going away I made a schedule of my 24 hour day plan and have gone through my daily routine picking out any issues to solve to avoid them springing up unexpectedly like some demented and rather terrifying Jack in the box…Jack in the box surprises are never appreciated, especially when you are living with mental health problems without a carer, so make a list and anticipate those problems before they can become an issue.

Tip 2 – Look into respite care: Making a list of challenges and things you are going to struggle with whilst a carer is away is all well and good but there is a chance that even when that list is made, things are still going to look incredibly daunting and perhaps unmanageable even if you break it down. When this is the case my tip would be to perhaps look into various institutions or options of places that you can go for respite care. It sounds a bit scary and dramatic but all across the country there are houses and facilities available for times exactly like these when a carer about to go off galavanting and they provide an option or place to stay whilst the carer is away so that you can manage living without them whilst getting the care you need. Crisis houses and specific respite houses will be around if you do a bit of research, although with this one it is important to look up these type of options as early as possible. Crisis houses may have spaces available more last minute (although usually there will be some kind of waiting list so getting exact dates is never certain), but respite care often needs to be planned in advance. Getting funding for a respite placement is another difficulty so this tip is not one without its issues (although if I could remove the issues for you please rest assured that I would), but it is certainly an option to consider or something to look into if tip one has left you still feeling that the idea of living without your carer is unmanageable. Indeed, personally I would say that looking for and going into respite care when carers are away is a great, safe and secure option that I would be head over heels for and going for myself during this week but alas because of late applications, lack of funding and various OCD reasons (like sharing bathrooms) this option is not available to me at this time and we have had to look for alternate ways to get through the situation….for example….

Tip 3 – Look into replacement carers: If like me, you find yourself incredibly intimidated at the thought of a period of time without your carer (even if that carer is away on a well deserved holiday that you fully support them in travelling on), but have not been able to access respite care either for lack of date availability or lack of funding (please insert comment about how desperate this country is for funding in the mental health department here), or OCD like complications like me where staying in your own house is preferable, there may be the chance of looking into an option of hiring or getting care from a replacement carer who can come and help you out in your own home and indeed this is the option that I am taking this week. The problem with this option is that it can be expensive hiring a nurse from an agency to come and support you, but luckily or unluckily depending on how you look at it, my parents have been so desperate and so worried that they have found the funds somewhere. Perhaps there are places and people who are eligible to receive this kind of care from the National Health Service (I know that the government provides hired assistance for people with learning difficulties for example, just not for people explicitly with mental health problems), so certainly check first to see if you are eligible for that kind of care but if not and if you do have the funds, my tip here is to know that hiring a replacement carer for a period of time is at least a possibility you may not have thought of (I know I certainly didn’t know this kind of thing existed until my parents ran into issues with my care for this particular holiday) and certainly an option to look into if you don’t think you will be able to manage being home alone.

Tip 4 – Make plans: When faced with a week home without my parents I shudder at the thought and my teeth chatter together like Scooby Doo’s after he has been through a particularly intense ghost chase. Thinking of all of those hours by myself/even with a nurse is terrifying, so as well as making a list of things you are going to need to challenge whilst your carer is away, I think it is important to make a list of things you can do to break down the time and give you structure. Being told to “survive the holiday” full stop is far too intimidating, so the key is to break it down into things that you are going to do in order to survive. Maybe this means planning to go on a walk one afternoon or planning a morning of crafty activities (by which I mean the arty kind as opposed to the sneaky sneaky burglar kind…no burgling whilst carers are in or out of the country please folks) but whatever it is make a rough plan for every day to stick to. Then, instead of “survive 7 days”, you will be faced with smaller and more manageable tasks like “watch a film for two hours” or “knit a penguin tea cosy” (other animal shaped cosies are optional but not advised). If choosing activities for each day is too stressful maybe simply write a list of ways to keep yourself busy, tear them up and put them in a jar and then when your carer is away and you find yourself at a loose end pick an activity from the jar and get distracting yourself with it. Either way time used productively is infinitely easier to manage than time spent simply worrying about where your carer is or what you should do to pass the time, so get a timetable going and make some structure for your time!

Tip 5 – Have a list of emergency numbers: In an ideal world, candy would rain from the sky, Donald Trump would not be president and your time at home without your carer would go swimmingly without a hitch but unfortunately we do not live in an ideal world (clearly evidenced by the current inhabitant of the White house and the lack of strawberry gum drops falling from the sky) and so we must face up to the fact that when carers are away, there is the potential for things to go wrong. Therefore it is important to prepare for such circumstances in advance by making a list of phone numbers of friends/family, support services, carers and crisis teams who you can call should things go awry. Hopefully you will make this list, hang it up beside the telephone and never need glance at it for the duration of your carer’s holiday but just incase things do go wrong, it is vital to have people in place who you can call on for help ready and prepared.

So there you have it! 5 tips as to how to manage when your mental health carers go away on holiday or at least 5 tips that I will be using over the coming weeks to survive my parents’ jolly jaunt off to Cyprus (they are going for a wedding…I am sure it is going to be lovely despite the fact that a holiday for my carers abroad is both delightful and terrifying). Whether these tips will be helpful to anyone else out there in a similar situation I do not know but whatever the case I thought I would try to help my pals out there and hopefully I have.
When carers go away it is always going to be scary but I will keep my fingers crossed that with these tips and that by hanging in there together, we will be able to get through. I guess there is only one way to find out…let’s give it a go shall we?

Take care everyone x

CarersAway

The Importance Of Listening To People With Mental Health Problems

This Wednesday the 14th of March is a very special day. Why? Because as of the 14th of March 2018 this little blog you are visiting right now will be two years old. That is right folks, as of Wednesday it will be two whole years since the birth of Born Without Marbles, nay not birth, the hatching of this tiny little mental health blog egg that I had been keeping in my oh so sufficient plumage until that moment (and my my do I have a lot of plumage).

How crazy is that? Pretty crazy if you ask me as two years is a really long time…Like a baby can go from a screaming ball of tears to a waddling and talking human creature in that time and I would like to think that my blog has undergone a similar amount of progress.
Now, you are going to have to forgive me in this entry as I fear I am going to sound very much like one of those actresses in a ball gown making a thank you for my Oscar speech and I am well aware that two years of running this blog does not entitle me to any award, but still today I really wanted to thank all of you out there reading this for making this blog what it is and for putting as much effort into reading it as I put into writing it. Indeed, you readers have helped and supported me more than you can ever possibly imagine. “How?” I hear you ask “What have we done?”. Well dear friends, you have done the most important thing that one can do when living with or dealing with someone with mental health problems: you have listened, and I think that this whole listening malarky is a seriously underrated piece of malarky on the scale of all things malarky.

I know people have messaged me in the past, people who may know or care for people with mental health problems and who have asked me what they can do to support them and the answer I want to advocate today is to listen to them. That is it.

I think a lot of people often find that when they have a loved one with mental health problems they want so desperately to fix their problems and unfortunately that is seldom, if ever, possible.
Mental health illnesses and disorders are complex and difficult to understand, intricate beings (which is why I have managed to write about and try and explain them for a whole two years now without really scratching the surface as to their mysteries), and I think that when people see themselves as responsible for curing a loved one it is simply too much responsibility to take hold of. It would be like asking one person to fight a whole army of sword wielding warriors who will need a lot of strategy and weaponry to defeat as apposed to one lone soldier with a mallet (for we all know it is notoriously easier to get hold of a mallet than it is to get hold of a sword…seriously where do they even sell those? Are they available on Amazon? Not that I want a sword of course…I am just seriously curious as to how one would obtain such a thing were one to be in need). If you ever set yourself the challenge of you and you alone curing someone with mental health problems then I think you are setting yourself up to fail.

This doesn’t however mean that when it comes to mental health problems and people who are struggling with them that it is best to do nothing, and that is where this listening thing comes in that I want to thank you all for today.

You see, when you live with mental illnesses, you live with a constant stream of noise and mayhem between your temples and that noise is difficult to deal with. Maybe that noise comes from the barrage of thoughts that come with depression, maybe they are the intrusive thoughts from OCD or an eating disorder, maybe they are audible hallucinations from psychosis or schizophrenia, whatever the condition, whatever the disorder, there is a lot of noise, and keeping quiet about it is a sure fire way of making that noise louder.
If people don’t speak about the noise, the noise tends to build up, louder and louder until all “real” sounds are drowned out by the cacophony and therefore it is important to have an outlet, a place to talk about and release a bit of that noise, not necessarily because that will make it all go away but because it will slightly lessen the burden that staying silent will weigh you down with.
That is where listening comes in. When you simply listen to a person with mental health problems, when you allow them to be heard, you are helping them more than you could ever know because you are sharing in that noise and therefore are giving it a little less power. I think when a lot of people think about going to see a therapist they assume that they will have these big elaborate contraptions designed to zap the mental illness away or physically remove it by some grand operation when really that is not what therapists do. There are no magical contraptions (unfortunately) and there are no magical zappers (also unfortunately), instead therapists listen, they hear and take on some of the noise because when you speak out loud about something it loses power. That is why in Harry Potter everyone is so scared of Voldemort, they don’t speak his name and by keeping it locked up in their minds as this big scary word they increase the fear. As Hermione wisely once said, “fear of a name increases fear of a thing itself”, and that is exactly how I feel about mental illnesses. When we fear them and keep quiet about them, we give them more power to control us, we give them authority as some big terrifying thing never to be spoken about and alright, I admit it, they are terrifying, but unless we talk about them and get them out into the real world, they cannot be tackled. If everyone were to keep their illnesses inside of their heads then they would be kept in a place where nobody else could reach them but by talking about them, they become tangible, they become part of our world and thus are something that can be dealt with.

Now don’t get me wrong, I am not saying that talking about a mental illness is going to cure it instantly, if ever, as I know very well myself that after a lot of talking and a lot of therapy, things are still pretty terrible (hey, I am nothing if not honest), but as terrible as they are, at least I have an outlet to get them out of my head both in therapy and on my blog. I have people who listen to me and hear all the pain it is hard to speak out about and if you have been a reader of this blog from the beginning, last week, or even if this is your first ever entry (welcome!) you have been a part of that and you have helped.

So what do I want to get across today as we approach the two year anniversary of Born Without Marbles? Simply this: That if you want to help someone with mental health problems, the first and best thing you can do is to listen to them, and if you have been listening to me for years or just today, then I want to thank you for hearing and taking on my noise. Trust me I do not know where I would be without all of you wonderful people out there listening and supporting me and I want you to know how much I appreciate, and how much all people with mental health problems appreciate it when people listen, when they are heard and when others are there to share in the noise. From the bottom of my heart and from my head to my toes, today, my message is thank you for being there. You do more than you know, and more than I can ever thank you for in a mere blog post. I hope you all know that I am also here to hear all of you struggling out there and share in any of your noise as well.

So happy second birthday Born Without Marbles and to all readers and mental health sufferers alike, remember to keep talking and to keep listening, for doing so is one tiny tactic we can use to tackle the mental health demon army.

Take care everyone, and thank you x

Anniversary

Dramatic Life Plan Changes When You Are Living With Mental Health Problems

You know that feeling where you don’t see a friend for a year (maybe they were backpacking around Australia or herding elephants in Africa), and then they come back for a cup of tea asking how things are going and you just sigh because there is so much to catch up on? Yeah. That exact feeling is the one I have today, only in this situation it isn’t that I haven’t written on my blog/spoken to you for a year (heaven forfend!). In actuality it has been a mere week since you last heard from me but what a week it has been and good lord with cheese and chopsticks do I have a lot to catch you up on!

Now, you remember last week when I talked about how I was about to go home after a five and a half month inpatient stay at my local eating disorders unit? Remember how I harped on about all the rules and regulations I had set in place to keep myself and my mental health problems on track and the importance of rules when living with mental health problems? Remember all that stuff I said about how I felt pressured to stick to the rules because if I didn’t there would be consequences including, but not limited, to my parents not being able to cope with me in the family home any more? (If none of this is ringing any bells I suggest you read the two posts that can be found, like aeroplane fire exits, here: The Pressure To “Get Better” When You Are Struggling With Mental Health Problems and here: Why Boundaries Are Important When Living With Mental Health Problems).
Good. We all up to date because you know that situation? Yeah, that situation has kind of sort of exploded all over the place and I have only been out of hospital for a week…

Indeed I can barely believe myself that it has only been such a short amount of time because so many things have changed. Like I said, I was only discharged last Tuesday, armed and determined with my rules and boundaries set my my parents to help keep my mental illnesses in check back home, but in this past week, all of those rules have gone horribly wrong.
From that first day back home my eating disorder looked at all of those neatly written out rules and laughed and I was smacked in the face by how much harder all of this eating malarky was going to be outside of hospital.
To be perfectly honest I do not understand it even myself.
For five and a half months I have been following a meal plan and now a simple change in location has completely thrown me off. I am not saying that I admit defeat already, far from it, but I can acknowledge that there is a serious problem and am well aware that, no matter how positive I try to be or how determined I am, I am currently unable to stick to the rules around eating certain amounts at certain times and not self harming that have been set.

“What is wrong with that?” I hear you ask “So you are breaking a few rules. This isn’t school, what are you worried about, getting detention or something?” I hear you cry!
Well no actually, I am not fearing detention but I have been fearing the consequences of me not being able to stay in the family home and in this past week it has come to my attention that me staying in the family home and living by my parents’ rules is, at this point impossible.

Now before I go on I would like to make it clear that my parents are not evil (well my mum is a little bit and she does cackle over a cauldron occasionally but that is a story for another day) and just because I am struggling with my mental health at the moment they are not kicking me out of the house. Far from it, they want and are doing all they can to support me with my insanity, hence why they set up these rules so that we could all try to live happily together, but to be blunt, they simply cannot cope with my madness any more for the sake of their own mental health (remember self care is important folks) and so me being unable to follow the rules has led to some consequences. What consequences?

Well, watch out because here comes a bombshell: I am not going to be living at home anymore. Yeah…I told you a lot had happened…

Like I said it was mere hours before we realised that I was not going to be able to live by the required rules and so, knowing that my parents could not cope anymore and that I didn’t want to put them through all of this again, I hopped onto google and started looking for a place to live. Mere days later I had impulsively used up my inheritance on a flat…yeah…I guess you could say things have moved pretty fast.

I don’t even know what to say or where to go from here because I am still so shocked and mind blown as to how all of this is happening and to be honest none of it feels real.

I am moving out.

I am in the process of buying a flat.

I have never lived by myself before and soon I will be living alone. WHAT IS HAPPENING?SOMEBODY STOP THE RIDE! I WANT TO GET OFF!

See what I mean about having a lot to update you on? Seriously, I have gone from living in an insane asylum for almost half a year, part of that time on 1:1 with a tube up my nose, to buying and living in a flat all by myself in the blink of an eye, and if I am honest, I have no idea how I am going to deal with it. Because of OCD and my eating disorder there are a million of normal every day things that I cannot do for myself from changing a duvet cover, to taking out a bin or washing a pair of socks and yet suddenly all of this responsibility is on me. Oh and how many Katies does it take to change a light bulb? THERE IS NO NUMBER HIGH ENOUGH BECAUSE THIS KATIE CANNOT CHANGE A LIGHTBULB. I AM GOING TO BE LIVING IN DARKNESS FOR THE REST OF MY LIFE UNLESS I GET SOME CANDLES WHICH I WILL PROBABLY DROP AND END UP BURNING THE WHOLE PLACE DOWN. I WON’T EVEN BE ABLE TO PUT THE FIRE OUT WITH WATER BECAUSE APPARENTLY FOR WATER YOU HAVE TO PAY A WATER BILL AND I HAVE NO IDEA HOW TO DO THAT EITHER. SOMEBODY HELP ME FOR THE LOVE OF GOD.

So yeah…that is my update, THAT is the latest Born Without Marbles news and an example of just one of the dramatic changes of plan that can occur when you are living with mental health problems…
Obviously it will be a while before I actually move out and into my new flat (turns out that buying property is far harder and more complicated than buying cuddly penguins…who knew?), but eventually that is what is going to be happening. In the mean time I will of course be living at home trying to stick by the rules as best I can and trying not to drive my parents completely mad but who knows how that is going to work out? Then again who knows how living by myself is going to work out because the only reason I am leaving home is because I am too insane and the last time I checked insane people weren’t the best at surviving in this world alone. Thankfully, whenever this flat does come through I will only be a five minute walk away from home and obviously my parents are going to support and help me through this more than I am probably giving them credit for, but purple onions and gravy am I terrified and filled with questions. How did this happen? How did my mental illnesses take over my life so much that they have led to me being practically evicted from my family home and forced to live alone where I cannot interfere with other people? How will I cope by myself if I can’t even cope with the support of other people? How on earth is this whole moving out of an intense inpatient setting and into an isolated empty flat going to play out? Well, truth is I have no idea. I guess we will be finding that out over the coming weeks together…

Take care everyone x

LifeChange

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

Should The Government Be Teaching Children To Count Calories?

When it comes to the government, they are always coming up with handy suggestions as to how people should live their lives. You know the stuff, “eat at least five portions of fruit and vegetables a day”, “don’t drink more than 14 units of alcohol a week” and “drive on the left hand side of the road” (actually that one might be a rule rather than a suggestion…I wouldn’t know. I failed my driving test and every time I asked my instructor for more driving tips after that, he ran away screaming which really did not help with answering any of my questions…)
Always ready to tell the population what to do then, for 2018, the government in the UK have come up with a new suggestion, complete with its very own catchy advert, where play-dough people morph around the screen and a happy jingle plays advising parents to teach their children to restrict themselves to “100 calorie snacks, two a day max”. Now I am not one to turn down advice from our dear Theresa May who is doing such a wonderful job of running the United Kingdom without any trouble whatsoever (pause for laughter), and even I can admit that it is a catchy slogan with a tune that isn’t bad either, but in my opinion this “handy lifestyle suggestion” is a terrible thing that should cease being taught to children immediately.

Obviously for someone (aka me) who is in hospital trying to recover from anorexia and is following a meal plan where snacks exceed 100 calories and are more frequent than twice a day, this kind of thing is unhelpful and triggering. On one hand I have dieticians and psychiatrists coming out of my ears (I really don’t know how they got in there in the first place), telling me that I need to eat this far higher meal plan than the one Theresa May suggests and on the other hand I have play dough people telling me to restrict my intake, which as I have said is obviously confusing and not particularly useful, but it is not just to people with eating disorders that I think this advert is detrimental, rather it is bad for the entire population (far worse for your health in fact than, dare I say, more than two snacks a day comprised of over 100 calories each).

The problem I think with any lifestyle suggestion or diet tip from any source, is that people hear it and immediately take it as gospel. In the real world however, nutrition isn’t governed by blanket black and white, one size fits all rules like that, and there is no such thing as a “diet expert”, only people who have done a lot of research about food and have opinions about it, a point highlighted to me during my brief stint working in a bookshop.
Unsurprisingly, this job involved various tasks including book shelving, and one day I was in the self help department (insert joke about how I need to spend a lot more of my time in such a section here), which was helpfully next to all the diet books. Therefore whilst shelving, I couldn’t help but get a good look at all the titles and diets being advocated.
Now generally, when it comes to reading about a topic, one would assume the more books you read, the more educated you become. For instance say you read 30 books about penguins, it is then likely that you will be more intelligent on that topic than someone who has only read one and that you would do better on any quiz regarding penguins. Alas, when it comes to nutrition, things are not like that, for as I shelved those diet books (working very hard I might add just incase my former boss is reading this…), I realised something ridiculous. Turned out if I were to read all of the diet books, take all of the information, all the “no carb”, “no protein”, “no fat” nonsense and I were to mush it together to make one overall diet plan (which you would think would be the best and most informed having been the culmination of so many books’ worth of information), I wouldn’t be able to eat anything. All the health advice added up together in the world and the conclusion from it? No food is safe, which I think is fairly unhealthy considering such a thing would lead to death, and, were we all to follow that advice, the extinction of all human life on earth. Marvellous. Therefore when it comes to rules like this “twice daily 100 calorie snacks” thing dolled out by nutritionists, taking them as gospel is never a good idea as they are merely opinions rather than facts.

“But for some people limiting snacks to twice daily amounts of 100 calories might be a good, healthier idea than their current lifestyle choices” I hear you cry and I am not going to disagree with you on that, but another thing I want to point out when it comes to guidelines is that they are not universal and are actually only helpful or beneficial to SOME people, which is why it is not helpful to have them rolled out as rules for the general population. As I have already said, this advert is obviously not applicable to people who are in recovery from eating disorders, but neither is it applicable to a large number of the population who all vary in height, weight, activity levels and nutritional needs. What about athletes for example. Is this rule supposed to apply to them too because I am pretty sure that that Mo Farah and Usain Bolt wouldn’t get very far nor would they get any more gold medals were they to restrict themselves to two 100 calorie snacks a day…
Okay I get it, there does need to be some kind of suggestion out there as to how to live a healthy lifestyle and it is important to teach children about food and nutrition but whatever happened to “general education” and suggestions like “eat your vegetables”, “everything in moderation” and try to have a “balanced diet” as opposed to these rigid rules and guidelines ridden with fixed numbers. Where pray did these numbers come from because last time I checked people don’t eat numbers, they eat food (and for good reason too. I once tried to eat a number nine and it was terrible. Tasted purely of pepper.)

It is just somewhat ironic that the whole focus of this campaign is to encourage health but encouraging children to see food in terms of calories and numbers really is a disordered habit struggled with by many people with eating disorders. If healthy snacking is the priority then advising healthy snack foods and providing possible examples would be a far better way to go about it because this focus on calories isn’t healthy at all. When numbers are brought up things start to get obsessive and this is where I think the problem lies. By specifying 100 calorie snacks they are labelling a strict limit to adhere to, but how ridiculously close are people supposed to stick to it? Is a 101 calorie snack ok? What if it is a really healthy snack that is slightly over? Should an “unhealthier” food be chosen instead simply because it fits the amount? Should we weigh already healthy fruit to check that they are “safe” in this new government scheme? Should children be taught how to count calories from the moment they exit the womb? Is that a normal healthy attitude to food? Seriously, think about it, does all of this sound healthy and worth advocating or more akin to rigid disordered behaviour seen in people with eating disorders aka a mental health condition needing treatment?

Overall then, if I had any say or control in any of this government malarky, I would say the whole “100 calorie snacks” with “two a day max” idea needs to be binned and for calculating numbers to be kept in children’s maths lessons in schools rather than in their lunch boxes or at the dining table at home. If you want to educate and give healthy food guidelines from the government then fine, go ahead, but when this advice is given it should be just that, GUIDELINES like the old “eat more fruit and veg” rather than strict, prescribed, rigid calorie counted rules that must be followed exactly and are carved in stone and sung over the breakfast table like some terrible national anthem.

If you have or even if you don’t have an eating disorder but are finding these adverts unhelpful, as hard as it is, my advice would be to do your very best to ignore them. Remember, just because it is prescribed by the government it doesn’t mean it is automatically healthy and it doesn’t mean that its obsession with numbers is not disordered. Nobody is the authority on rules regarding food and diet, it is all opinion, and strict rules, hell even general guidelines, are not applicable to everyone.

Take care everyone x

GovernmentFood

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 Of Knowing What Counts As “A Behaviour” When You Have An Eating Disorder

How do you tell the difference between an elephant and a letterbox? You check to see which one has a trunk and which one is filled with neatly addressed handwritten letters that will soon be lost in the abyss that is “the postal service”.
How can you tell the difference between a brand new slipper and a boomerang? You throw it to see which one comes back and smacks you in the face.
So far so good (apart from the fact you may have just been smacked in the face with a boomerang or lost a perfectly good slipper), but now for the third question:
How do you tell the difference between the genuine preferences of someone with an eating disorder and the disordered behaviours of someone with an eating disorder? The answer? With extreme difficulty…if at all.

When you are on an eating disorder unit, the food aspect of things/what you can and cannot do with food, is a lot more regimented and controlled by sets of rules than it is in normal life.
Rules will vary depending on what hospital ward or inpatient unit you have been admitted to, but as a general list of examples these rules will be things like “no eating cereal with tea spoons”, “no breaking food up into tiny pieces”, “no sleeves at the dinner table”, “you must scrape the plate that you are eating from clean to complete the meal”, “only X number of minutes to eat your meal” and “no inserting parsnips into the nostrils of the person sitting next to you” (pretty sure that last one is also relevant in real life actually but I am not quite sure…my mother was never very clear when it came to table manners.)
These rules are often frustrating and can seem a bit harsh but they exist because often an eating disorder controls how a person eats and behaves around food, as well as how much or little of it they eat, so part of treatment during recovery involves tackling those food behaviours as well as things like the amount of food someone might be eating. Like I said it can be annoying, but it makes sense. Take the “you must scrape your plate to complete a meal” thing. It may seem over the top (and is a rule that will destroy the lovely willow pattern adorning all of your best crockery), but were it not for rules like that in hospital, there is the risk of people arguing that they have finished their meal when really all they have done is smear it across the good china.

With behaviours like that, I think it is easy to tell the difference between them and genuine food preferences as I don’t think I know any people without eating disorders who “prefer” trying to mash a lasagne into oblivion rather than consuming it.
There are however, a lot of actions people do where it is far harder to tell if the person is making a genuine choice or following a behaviour, and in these situations it is less like trying to distinguish an elephant from a letter box, and more like trying to tell the difference between an elephant, a tea pot and a vacuum cleaner (if you line all three up together you have to admit they do look rather similar…trunks, nozzles and spouts are easily confused…I learnt that the hard way…and broke a teapot).

For example at the hospital I am in at the moment, there are certain rules regarding condiments such as “only two pepper/ketchup/vinegar/mayonnaise/brown sauce etc sachets per meal”. The logic behind this is that some people with eating disorders tend to totally cover their food with a certain condiment in order to make it all taste the same/spoil the food and make it taste horrible as a punishment etc.
Then again, as well as people who use pepper to burn the roof of their mouths off by using it excessively, there are people who use what looks like an excessive amount of pepper simply because they like it. Every time my Dad eats a meal he uses so much pepper that even people scuba diving at the bottom of the Atlantic start sneezing because he likes the spice, and I have a friend who uses what may look like a lot of salt because she has been brought up using that amount and things taste wrong without it. Neither of these people have eating disorders, but they would still struggle living by the rules that are in place to help someone in recovery from a disorder. I guess you could say that the way you tell the difference is to see which came first, the food preference or the disorder, but that isn’t as easy as it sounds. Eating disorders are sneaky, they slip into your life gradually without you really noticing, so it is rare for someone to be able to pin point the day they officially became unwell.

What if my Dad, who currently does not have an eating disorder, developed one in years to come and had to go into hospital? Or my friend who likes a lot of salt? They might, quite rightly, argue that their preferences existed years before their illnesses began and they may be right but the thing is, in hospital, that doesn’t really matter and this is where it gets frustrating. Once you are tarnished with the Eating Disorder brush, suddenly people assume that EVERYTHING you do around food is because of that disorder and they rarely give in or believe you even when you are expressing a genuine dislike. It can be really annoying when you know that your love of toast that is not particularly well cooked is because you like soft as opposed to crisp bread, yet when you are consistently told that everything you do is disordered, sometimes you can start to doubt and be unable to tell the difference between your own choices yourself (aka the is it an elephant, teapot or a vacuum cleaner situation).

How about timings and things like time limits on eating disorder wards? Admittedly they are necessary to avoid still working on Monday’s bowl of cereal at Sunday dinner time (rather soggy cereal I would imagine), but in addition to timings perhaps being affected by disordered thoughts or behaviours, people naturally have varying eating speeds. I certainly know that in my household my Dad will always finish his dinner a good 10-15 minutes before my mum for the simple reason that he has a bigger mouth and more violent set of gnashers (not abnormally large I might add…like he is still a handsome chap and isn’t frequently being mistaken for a shark who needs to be sent back to the aquarium…just clarifying…love you Dad.)

The main rule/“behaviour” that got me thinking about this topic however, the rule I have seen come up in every single one of my admissions to an eating disorder unit and the rule that is carved in a stone tablet and worshipped on a mountain guarded by holy cherubim:

“Thou shalt not dunk biscuits”.

Some of you reading this, who have never heard of such a rule, may be a little shocked, stunned and perhaps distressed to hear that there are people all over the country being forced to eat rich teas that have never actually taken a dip in a real mug of the beverage after which they are named (I know, it is upsetting but we can get through it).
Again, as with all hospital rules there is a reason behind it, that being that people sometimes submerge and drown their biscuits rather than dabbling in a quick dunk and then smear the soggy remains around the inside of their mugs or leave them in sorrowful abandoned mush mountains at the very bottom.

The issue though, comes when you are someone who wants to safely and appropriately dunk their biscuit, yet are prevented by the rule that may not be relevant to you. Of course rules have to apply to everyone on the ward to make them fair, but that is what is annoying, i.e. having an eating disorder and then having EVERYTHING you do with food put down to your disorder when maybe you have just grown up liking a lot of ketchup on your curly fries, or genuinely prefer the texture of a cookie that has had a quick swim in a mug of hot chocolate. Dunking biscuits CAN be a disordered behaviour, but it isn’t always.

Just imagine if the world had to live by eating disorder ward rules with the act of dunking a biscuit being classed as a disordered/unhealthy behaviour and thus banned for all. How would any of us ever eat an Oreo? The dunking aspect to those delights is even in the damn advert! They literally explain how to eat them on the packet! First you twist it, then you lick it, then YOU DUNK IT. If that bit was deleted from the process the country would grind to a halt and living rooms across the world would be filled with poor distressed people holding opened licked Oreos and crying out in agony “WHERE DO I GO FROM HERE?” Think of the number of teeth that would be broken on undunked ginger nuts!

You could maybe be a generous dictator and say that only people who appropriately dunk their biscuits are permitted to do so (something I have asked for on multiple previous admissions), but how can you tell if someone is dunking appropriately? What if someone is genuinely dunking for the resulting soggy biscuit end goal but is such a poor judge of the strength of their chosen biscuit that they get the timings wrong and remove their Custard cream or Bourbon from their brew not to find a perfectly melted vanilla or chocolate cream centre but instead a blank space, an empty half in which biscuit perfection had existed seconds before it was too late and the perfection turned into a sinking disappointment of heartbreak, sorrow and missed opportunities.
Should biscuit dunking be classed as an eating disorder behaviour just because it can sometimes be used as one or can it just be a preference?

Overall then it is clearly very difficult to tell the difference between an eating disorder behaviour and a genuine food preference, especially when you yourself have the eating disorder. I guess when it comes to people who have no issues with food the answer is obvious…until that person is unfortunate enough to develop the disorder and we are caught in the whole confusing “which came first the soggy biscuit or the mental health problem?” dilemma which has plagued scientists for years (scientists who I feel are doing valuable work but are also perhaps taking advantage of their right to order in free biscuits from the big companies under the guise of “research purposes”….)
Of course there will always be ways to figure out the disordered act from the genuine preference but it isn’t always as clear cut as the elephant and the letter box example and sometimes even knowing your own reasons for doing things can get you into a confused muddle of soggy biscuit yourself.

Take care everyone x

ElephantHoover

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

Things You Will Need When You Are Admitted Into A Psychiatric Hospital

Before you move house, you need to pack your life into a van. Before you go on holiday, you need to pack suncream and the inflatable dolphin into a suitcase, and before you go out rambling in the wilderness, you need to pack a picnic in a picnic basket (preferably one of those wicker ones with a gingham tablecloth and lots of little boxes inside…one must never go out rambling unless one is accompanied by a picnic).
There are however some things that are a little less fun to pack for, those being admissions to a hospital or inpatient psychiatric unit, which is nowhere near as much fun as a picnic (and involves 100% fewer wicker baskets…By God I love a wicker basket).

When I decided to write a blog about this topic I was therefore going to call it “Things you will need to pack for an inpatient admission” but as I have started writing I realised that sometimes when it comes to mental health hospital admissions, they are not planned like a two week cruise around the Mediterranean, and there is seldom time to “pack”. Even when an admission to a unit has been planned, you are going to be so nervous about it the night before that you forget to pack anyway, so instead here I thought I would offer a little help to all those who find themselves in that situation by providing a list of things that you will need during an admission to a mental health hospital.
It doesn’t matter if you are making a list of things to pack the night before or simply things you now need to start begging family/friends/online delivery people to bring to you because you were not prepared and only came onto the ward with a one way train ticket to Exeter (trust me, it happens…). Whatever the situation, this blog post is here for you, so lets get on and start this fabulous list of things you will need during an inpatient admission to a mental health hospital (things you will need if you have fabulous taste like me that is…)

BASIC LIFE THINGS: You may think that this is a rather obvious logical point to make but remember, mental health admissions are stressful times where “obvious logical things” turn into “I like ducks”, and you would be surprised by the number of people who turn up to hospital without a toothbrush (warning, this may make teeth angry and cause them to phone the tooth fairy emergency helpline for immediate assistance. Don’t say I didn’t warn you.) So yeah…I am not going to list all the miscellaneous nonsense you may use every day, but as a general note to start off with, when you are in hospital, you are probably going to need a lot of the general nonsense you use everyday (toothbrush/toothpaste/underwear etc.)

MOTIVATION: Of course I mean this point in the emotional sense of the word, but when you are isolated in hospital it can be easy to forget why you are there and what you are doing in this inpatient bubble, so practical pieces of motivation to get you through are also essential. Things in this category can include photos of friends or family, motivational books about people who have been through recovery for your disorder, quotes or even little prompts to give you a little boost when your brain refuses to do the boosting for you (e.g taking something like a list of things you want out of life to have at your place at the table on an eating disorder ward to help at meal times). I have known a lot of people to go all out with motivation and to bring enough cards/quotes/photos to decorate their entire room into a cave of inspiration (if that is allowed on your unit and you are not in a stripped room that is), so if that would help you, do that. Personally though, I prefer not to put up too many decorations because I am always so hopeful about leaving that I refuse to accept the idea that I should settle because I may be there a while…

THINGS TO DO: When you are in a psychiatric hospital it is likely that there will be things going on. On the week days there may be things like therapy groups, 1:1 sessions and opportunities for visitors, but aside from all of those things and the “spare hours” that will be taken up by things like crying hysterically, you are still going to end up with a fair bit of free time, especially on weekends when it is quieter and a lot of patients may have leave. Keeping yourself occupied therefore is going to make time pass quicker and distract you (a bit) from what is going on. For example on my ward there is a current craze with origami and people are making paper cranes faster than I can count (I tried to get into Origami too and managed to unfold one of these aforementioned cranes into a normal square piece of paper again but apparently that “isn’t the point”). There are also patients who knit and live in giant balls of wool, people who colour with crayons, draw, and there are patients like me who get through the day either by writing or by tossing reality out of the window and reading to get lost into alternative fictional worlds (This week I read “The Secret Garden” a book I highly recommend for times in hospital when you cant go outside and see a real garden yourself.)

COMFY CLOTHES: The first time I ever packed for an inpatient stay, I put all of my nice going out clothes into my suitcase and took them to the hospital ready to co-ordinate my outfits every day so that I would “look nice” for the other patients. I also wore mascara to a place I was highly likely to start crying in upon arrival. I was an idiot.
Listen, I get it, people like to look nice both for themselves and for other people but let’s be real, a psychiatric hospital is not a fashion shoot (cameras are not allowed), and after five minutes neither you nor anybody else is going to care what anyone looks like because you are all too busy being caught up in fighting your head demons and managing general anxiety. Even if you are not worried about what you look like or what people are thinking of your sense of style, “nice clothes” are simply not practical. When you are in hospital you are going to want to be comfy. Imagine you need to curl up on your bed for a good sob or find that you are so anxious that you start having panic attacks and problems breathing. Maybe things have got a little bit out of hand and staff need to carry you somewhere, carry out a quick blood test or give you an injection to calm you down. All of those things are going to be a hell of a lot more pleasant (as fun/pleasant as being injected in the rear can be at least), and a lot easier/more comfortable if you are wearing comfortable clothes rather than a corset and, skinny jeans.
Don’t get me wrong, if you want to dress up because it makes you feel better/more human then feel free to do so. I know a lot of patients who still like to wake up, wear a fancy skirt and put make up on in the mornings because that is what works for them, makes them feel less “mental hospitally”, more normal and lifts their mood (I am not one of those people…) However, even the people with the nicest most fashionable clothes will need a onesie and a lot of baggy trousers for “those days”. I would also add slippers to this both because they are comfy footwear and make a nice slip slop sound as you walk down the corridors. Trust me, stiletto heels are not a good idea (they tear the evacuation slide…or am I getting psychiatric hospital attire confused with ideal footwear for planes…)

TACTILE/FIDGETTY DISTRACTION THINGS: When people get anxious, their bodies get filled with adrenaline, and to calm down, that adrenaline needs to be released. Often this can happen via what the professionals call “unhealthy coping mechanisms” and that is not ideal because…well…it is unhealthy, and therefore you need other practical tools you can use to keep your hands busy releasing adrenaline whilst the rest of you remains safe. These things are different from the “things to do” category because they are not things that require any particular concentration, brain power or coherent thinking, these are for the times when your head is so loud that you cannot remember the alphabet and just need something to cling onto. I personally have what is called a “Tangle” (this weird thing that can be bent into all different kinds of shapes), and a fidget cube. Other things people may use include stress balls, squeezable spikey rubber balls, fidget spinners and putty. Sometimes things like a pebble to hold or little pebbles to pass from one hand to the other can also be helpful, but I will leave that up to you to decide because some people may not find those items to be safe to be around in a stressful situation.

And now to the final category, the most important thing you will need for an inpatient admission to a psychiatric hospital…

SOMETHING TO CUDDLE: Enough said. I don’t care how old or cool you are, everyone needs a cuddle once in a while/all the time so pack a damn teddy bear for the love of God.

So there you go! All the things you could possibly need to survive an inpatient admission in a psychiatric hospital. Obviously feel free to take other things as well, but as a basic guide I would say this list is a good one to start with.
I should point out before I finish here that as well as a list of things you will need to take to an inpatient unit there is usually a list of things that you should not take (like sledge hammers…mallets are ok though), so on the whole as a final tip, when you are packing, stick to things that are softer and squishier than a pick axe. If you are currently in an inpatient admission or are approaching one I hope this list helps, and if you are not then thank you for coming along for the ride anyway! I am thinking of and supporting you all, wherever you are, you are not alone in your fight.

Take care everyone x

InpatientPacking