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Why Boundaries Are Important When Living With Mental Health Problems

/ bornwithoutmarbles / 11 Comments

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

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The Unpredictability Of Life With Mental Health Problems

/ bornwithoutmarbles / 14 Comments

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

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

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

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

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

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

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

Take care everyone x

FortuneTelling

Birthdays And Mental Health Problems

/ bornwithoutmarbles / 14 Comments

When I was younger and heard adults saying things like “I just want to forget about my birthday this year”, I thought that adults were crazy and needed to seriously reconsider the way in which they were living their lives. Why on earth would anyone ever want to forget about their birthday?

For me, birthdays were something to look forward to and something I couldn’t forget about if I tried. Birthdays were about choosing which soft play area you were going to take all of your friends to for the party, buying rainbow coloured bouncy balls to fill party bags with and deciding whether you wanted a Thomas the tank engine or Spice Girls birthday cake ready to decorate with a flaming beacon of candles. Birthdays were about unwrapping incredibly exciting and complicated plastic contraptions that you would then spend the rest of your day watching your mum struggle to assemble amidst an encyclopedia of instructions in every language but English, before finally making it look like the thing on the box, only to realise that batteries were not included, causing your mother to curse the creators of Toys R Us and howl at the moon until the early hours of the morning, Barbie’s camper van standing motionless and taunting you from the corner. Birthdays were about wearing a badge with your age on it to school so that everyone would know how very mature you were and how much respect they should bestow upon you, and no birthday was complete without a trip to TGI Fridays where you would stand on your chair like a king whilst a chorus of red and white striped waiters belted out “Happy Birthday”, the performance concluding with rapturous applause from all around and, if you were lucky, an extra gummy worm in your Mississippi mud pie. With all that to look forward to, how could anyone dread a birthday?

I was sure that I would always look forward to my birthday and would never be one of these fools who looked upon the occasion with anything other than spine tingling excitement. I was wrong.
For the past few years, despite little Katie’s best intentions, I have become one of those people who wants to forget about their birthday, and I think it is because as you get older, birthdays don’t mean the same things as they used to. They become less about gummy worms and birthday cakes and more about time passing you by, life passing you by, which isn’t something you really care about when you are younger and your main focus is getting the bit of icing on the cake that has your favourite cartoon character on it. On top of that however, when you are mentally ill, I think they are especially hard because for me at least, a birthday can feel like a reminder that you have wasted another year drowning in anxiety and the older you get, the longer you have been stuck with this mental illness bothering you all the time.

That said, I guess you can sort of see birthdays and that marker of time passing as a positive thing. This year for example, I turned 25 (I did it last Thursday as a matter of fact and luckily, despite all the dreading and worrying about it talked about in this post, I really did have a lovely birthday, so if you sent me a birthday message or said hello to me at all on the 22nd June then thank you for being someone who made it special. I really appreciate you all so much). Alas! I must get back to the point!
So, turning 25 means I will have been unwell for 14 years. On the plus side, whilst a depressingly long time, it is an improvement in the sense that I can say the number 14 because it is a safe number, unlike the number I used to have to say, (the one that comes between 12 and 14), which is a somewhat difficult number for me to handle in terms of OCD (YAY SILVER LININGS).
Also there is something rather motivating about birthdays in that they often inspire you to make goals of things you are unhappy about and want to change before the next one.
Indeed, I think that as the number of years I have been ill has gone up, the more motivated I have become to fight my illnesses and push as hard as I can for recovery even when it involves doing something scary.

During the first years of my illness when I had to go back a year in school and take time out of education to go into hospital, I was motivated to fight purely because my illnesses were making me unhappy, but not so much because I realised what I was missing out on whilst stuck in my head. Ok I often couldn’t leave the house and I missed out on a few sleepovers with friends, a couple of school trips and several opportunities to share a pizza and watch a movie on a Saturday night, but to begin with, missing the odd pizza isn’t that big a deal. Obviously I would have liked to have done all the things like going bowling with friends and eating popcorn at the cinema, but for me being safe at home not having to touch or eat anything, felt a lot more comfortable. I would have rather stayed in my little bubble avoiding as much anxiety as I could, even if that meant being a little bit lonely, than go out of my bubble and cause myself a lot of distress trying to wear a pair of bowling shoes or eating a mouthful of popcorn. Staying safe was my priority, and if that meant missing out on a few sleepovers/meant less terror, that was a necessary sacrifice I would take. Why terrify yourself for weeks and weeks just trying to get the courage to see a friend for an hour? Better just to avoid it.

However the longer you live with mental illness, the more those little things add up over the years, and suddenly you find you have not just missed the odd sleepover, you have missed hundreds of sleepovers, hundreds of moments in which people took photos and made memories that they reminisce about and fondly recall with sentences beginning “Oh my goodness do you remember when…”. After several years, you haven’t missed one bucket of popcorn, you have missed an entire swimming pool worth of popcorn (not that I advise you put popcorn into a swimming pool…just trying to get the image of how much popcorn we are talking about across), and that amount of popcorn can’t be caught up on as easily as the one bucket you missed in the first place. As the days become months and the months become years, you realise just how much of your life you have missed out on because you were too scared to take part in it, and suddenly the motivation to work even harder to stop the years passing by without you noticing increases, because you finally understand how rubbish it feels to be left so far behind everyone else.

However at the same time, whilst the longer you live with a mental illness the more anger and frustration you have at it to motivate your recovery, the further entrenched you are in that illness and thus the harder it feels to get better. It is a catch 22 situation, the most vicious of all the vicious circles.

Time passes, you get angrier at all the time wasted, you become more motivated to fight but then find it is harder to fight than the first day you tried to challenge yourself because the illness has used the time wasted to dig its claws into you even further. Odd things that started out as little quirks to keep yourself safe become engrained habits and habits are a lot harder to break than things you only did a few times. I have smoked only one cigarette in my life and I will be honest, I hated it. It was like swallowing a smelly smokey fire. Therefore deciding to “give up” on the idea of smoking after that cigarette was not a challenge at all. I had spent longer as someone who didn’t smoke than I had spent as someone who did, it wasn’t a habit and I was not addicted or used to the comfort or feeling of a cigarette in my hand. Now however, I have officially been mentally ill for longer than I have ever been not mentally ill and I have dug myself into a hole so deep that it is far harder to get out of. Years ago I didn’t go to a meal out with friends because it made me uncomfortable, but that uncomfortable feeling has built over the years, and now I don’t go because I am terrified. Eating out doesn’t make me anxious, it makes me feel like I am dying on the inside. The longer you are ill, the more set in your ways you are and the harder it is to get better.

This year then, as always, though I dreaded my birthday as it scares me to think how long I have been trapped in my own mind, I am trying to see it as a positive motivation for change, an opportunity to say “this past 14 years has been hell and I am determined to fight as hard as I can to make sure that number doesn’t go up by one every time my age does”. I am fed up, truly angry every year as I see the growing list of all the opportunities I have missed out on and I really do want things to be different. It is just difficult, ageing with mental illness. As the years pass you may feel more motivated, but at the same time, you just feel more trapped.

Take care everyone x

BirthdayBlog