Unit

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

/ bornwithoutmarbles / 11 Comments

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

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

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

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

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

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

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

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

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

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

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

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

Take care everyone x

PiggyConfidentiality

Advertisement

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

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

/ bornwithoutmarbles / 21 Comments

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

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

/ bornwithoutmarbles / 16 Comments

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

The Difficulties Of Communal Life In An Inpatient Setting

/ bornwithoutmarbles / 8 Comments

If you put one fish in a fish bowl, that fish will probably be very happy, especially if you give that fish one of those little plastic castles that sit at the bottom of fish tanks in cartoons. Fish love castles. Nothing makes them feel more content than a nice turret.

If you then add another fish to this bowl, there is a chance that both fish will be happy and will be able to enjoy their plastic castle together, ruling over their water sphere of a home like aquamarine royalty. Add another fish to the bowl however, and the chance of problems will naturally arise as while all fish love castles, every individual fin flapper has their own specific tastes and preferences. Some fish may like a drawbridge on their castle, some may enjoy a moat, maybe there are even a rare few who, dare I say, like their castles without those lofty turrets.
The more fish you add into the fishbowl then, aka the more individuals you have trapped in a confined space, the harder it will be for those individuals to breathe/swim about without accidentally smacking a passer by with a wayward fin and in this sense, psychiatric units are very much like fish bowls (except with really mentally ill fish and no castles…God I wish I had a turret…some fish don’t realise how good they have it).
Like fish bowls, psychiatric units are small confined spaces where you can often find yourself trapped living amongst a group of people you have never met before and it is unlikely that you will get along with all of them, not because any of them are bad people, but because all people, like fish, are different. I think it is easy to think of going into hospital as a very private, individual experience between the patient and their inner struggles and in essence I suppose it is, but that doesn’t take away the community side to inpatient treatment and how difficult it can be living in close proximity to people who are, like you, working through their own personal hell.

No matter how much you go into hospital focusing on yourself, I think a lot of people forget or don’t know about the community side that is bound to be a part of any inpatient admission. Every inpatient setting and inpatient group will have a certain feel, an ambiance if you will that creates some kind of atmosphere, be that positive or negative, on the ward. Sometimes that atmosphere can be constructive and helpful in advancing recovery but as with the fish in the bowl, eventually there are going to be disagreements about whether you install a drawbridge or start knocking down all the turrets, and that can be really difficult and affect your personal treatment more than you would like to admit.

It is a side of treatment that is really difficult to manage and not often discussed, but over the years I think I have realised that there is only one way to manage the difficulties of life in a fish bowl with your fellow mental mackerel, that way being:

  1. Be friends with everyone
  2. Ignore everyone

On the surface, trying to do both of those things are the same time sounds like kind of conflicting advice to give, but then again a lot of great things in life involve components which at first appear to be conflicting.
Just think of the person who invented sweet and sour sauce or the hero that discovered salted caramel. People said they were crazy, that their ideas involved too much conflict between opposing opposites, and where are those legends now? Living the high life in their very own castles (with turrets). And as for the naysayers? Why, they are all cowering shamefully in their hollow lives devoid of delightfully sticky sauce accompaniments with their egg fried rice and of sweet milk chocolate coated toffees set off by the salty tang of the sea.

Personally, I really struggle with the communal living side to hospital admissions and every time I go into an inpatient unit I privately vow to speak to no-one, close my eyes and hope that because I can’t see anyone else, they can’t see me either…But like I said, this is unrealistic and at the end of the day, it doesn’t matter how social or unsocial you intend to be, you do have to live with these people and if you want to survive a shared space of communal compromise, you are going to have to get along to some degree.

I guess it is very much like any communal office or work place where a group of people are forced to spend long periods of time together, regardless of whether or not you have anything in common. Though I have never worked in an office like you see in the movies with all the rows of desks and dividers, I highly doubt that people who do work in those kinds of places would be willing to give all of their colleagues their last Rolo, but you couldn’t get through the day if you held grudges and took things too personally, and I am pretty sure people would be fired if they weren’t at least civil to each other and forced themselves to be a little extra on the polite side.

Maybe you have an office neighbour called Janet who keeps stealing your stapler, puts empty cartons of milk back in the fridge after making a cup of tea and is well known for dropping those little white paper circles that fall out of hole punches all over your paperwork (if this is you then damn it Janet, pull yourself together and keep your little white paper circles to yourself for the love of God.)
If we all had a Janet and behaved as we wanted to (aka smacked her over the head with that stapler she clearly loves so much and changed all the passwords to “Empty milk cartons go in the bin Janet”), it is unlikely we would keep our jobs for very long and nobody would get anything done in life. To keep the country moving and employment rates up then, people tend to bite their tongue at work around their own personal Janets, to keep the peace. That is sort of what it is like in an inpatient setting. You will be in a close proximity to a variety of people for large portions of the day and basically if you want to survive, you have to treat others with all the kindness and respect that you can muster and get on, as good a group of friends as you can.

Sometimes it isn’t even hard to be friends with everyone in an inpatient setting and it is a thing that comes naturally with no extra effort required. After all you are all stuck in a very similar situation going through similar experiences that not everyone in the outside world can relate to. Whilst in hospital it is easy to feel disconnected and isolated from any friends or family members who come into visits talking about holidays abroad and new umbrella decorated cocktails they have tried, whilst the only trips you have been on have been to a walled garden and the only cocktails a brand new combination of anti-psychotics (little umbrella not included).
Fellow patients will be able to relate to that kind of thing and can certainly make you feel less alone. They can also be a great support system who you share a lot in common with and often the most helpful things you can find in treatment are people you can relate to, who maybe give tips as to what has helped them in the past. I have even had admissions where the whole group of patients have got on so well that it has actually been like one giant sleepover in a boarding school with friends and you build such strong relationships that you won’t know how you would have survived the inpatient experience without them. Dare I say it, on special occasions when the brain devils are not out to play, you may even have a few laughs and leave inpatient with a fondly remembered evening of choreographing dance routines to “Spice up your life” by the Spice girls, after a rebellious water fight to cool off in the summer in the wet room (not that I have any experiences of such things personally you understand).

That said, when inpatient it is also important to stick to the second “way” of surviving the experience, aka part two “Ignore everyone”. This is not to say that when a fellow patient greets you with “good morning”, you keep your eyes on the floor and pretend that they don’t exist (a nice smile and “morning” is a far nicer option for both parties involved), but you do need to keep yourself to yourself to a certain degree. As helpful as it is having people you can relate to, it can also be triggering in ways detrimental to your mental health and wellbeing.
When you are in the fish bowl, everything is intensified and feels more dramatic than it might do in the outside world. In the outside world for example, like in the workplace, there is one Janet out of a global population of several million billion thousand other humans (that is a rough estimate…I lost count). Thus your Janet/difficult person in life makes up a tiny 0.000004% of the population or something and so it is easy in a way to avoid that person, avoid conflict and take yourself out of a situation. Say however that when inpatient there is one person you don’t get on with and it is a 10 bed ward, that is ten percent of the population, so the actions of that person can feel a lot more dramatic.
It is therefore important not to get too caught up in other people’s business and let them affect you , rather it is safe to keep yourself to yourself with your blinkers on and focus on your recovery and goals for admission.
I know I really struggle with getting caught up in the inpatient bubble, very distracted and involved in the lives and worries of people in the other bedrooms along the corridor and it is only when you start to get things like leave that you realise there was a whole other world still outside of those walls and half of the things that were incredibly dramatic whilst on the ward are totally irrelevant back home. When you are in hospital, those people you see everyday are constantly on your mind because they are constantly in view, but when you are home with family and friends living your life and benefitting from all the hard work you did on the unit, you are unlikely to think of them at all (unless you keep photos of them on your bedside or something…don’t do that…that would be weird.)

As much as an inpatient stay is an individual experience then, there is a lesser discussed fish bowl style communal element and that is going to be difficult. There are however ways to deal with it, and for me, this blog post is how I get through and is the advice I would give to anyone else who is currently stuck in a mental hospital fish bowl or anyone looking to an admission in the near future. Never forget that any unit is really just a small glass orb on a coffee table and there is a flipping massive ocean to swim in when you get back out.

Now if you don’t mind, I am off to the nurses’ office to demand we get an immediate emergency supply of turrets on this ward. Fish get whole castles and damn it. I WANT A TURRET.

Take care everyone x

Fishbowl

How It Feels To Be Recalled To Hospital Under A Community Treatment Order

/ bornwithoutmarbles / 16 Comments

If someone had asked me what it feels like to be recalled on a Community Treatment Order (part of the Mental Health Act), before it had ever happened to me, I am not sure what I would have said. Possible guess answers that I might have offered would have probably included things like “scary”, “shocking” or “dramatic”. Probably one of the last answers I would have given, would have been “it feels like having your car stolen by a band of incredibly apologetic thieves who are very sorry for your loss”. However, as it turns out, that is exactly what it feels like…

As you will all know from the fabulous explanation of the Mental Health Act that I posted last year and linked to again last week (hint…it is right here: Demystifying The Mental Health Act…With Penguins), when you have a CTO, you have a list of conditions hovering over your head which must be adhered to if you want to avoid being legally recalled to hospital. Rather than conditions hovering like ominous wasps at a picnic who like a look at your jam sandwiches though, I like to think of them as “things that hold you accountable” or “reasons to do things”.
Every time I was scared to challenge my eating disorder and follow my meal plan I had an argument I could use, that being, “you have to do this because otherwise you will lose weight and go back to hospital”. It was a system that worked but admittedly I felt really trapped by it.
Every day I would wake up and force myself to eat a number of calories that made me feel depressed, knowing that it would keep me at my CTO weight which felt equally depressing.

All I wanted to do was give up, give in and lose weight but I felt I couldn’t because that would only involve being recalled to hospital which was simply not an option. My CTO weight was the border to a war zone and I was not taking a single step into no man’s land.
Then however, the recent hospital surgery medical drama, naturally led me to lose weight and I crossed that barrier without even intending to. Before, that CTO number had held a power over me, every digit had felt significant, like a law from the gods that I would probably find carved into one of those massive rocks at Stonehenge if I visited and looked close enough (a lot of people have theories as to why those mysterious stones are there including “for religious reasons” and “rituals”…My theory is that they were simply put there by some cheeky prankster who wanted to leave a pile of stones lying around so that future generations would ask “why the hell are those stones there?”)

When I went under the weight however, the power of that number and the spell was broken. I had thought that one step over the border would have resulted in guns and tanks sending bullets and bombs flying all over the place…but nothing happened. Of course it would have had the weight loss been “my” fault, but I had an excuse, my appendix did it not me, so it was almost allowed. Obviously the CTO weight still mattered and I had to get back to it, but with this medical “it isn’t my fault” get out of jail free card, I knew that I could take advantage and lose more weight without getting into trouble.

Thus it was that, as you know, I ventured further into no man’s land, and it was a sudden surprise when after all this “oooh this feels quite safe and allowed” turned into the previously expected “guns and tanks and swords and back to hospital for you”. Unsurprisingly, it was pretty distressing and traumatic, so a lot of people have been very sympathetic which has been lovely. I really appreciated comments from people online who were not directly involved in the situation because they felt genuine, but it is when we get to the words of the people closest to me that we get to this whole “I feel like I have had my car stolen”.

To use another analogy, I suppose you could view my body as a car that the garage have been keeping very strict rules on. I may have owned the car but there were restrictions as to what I could do with it, what colour I could paint it and how far I could drive. Then, when the CTO barrier was broken, I suddenly regained control over that car, so I grabbed that wheel, painted it purple and zoomed off into the distance (I suppose if we are combining this with the other analogy I zoomed it off into former no man’s land…just like people did with BMWs in World War Two…I may need to retake GCSE history).
With the car all to myself I set my speed limit, I pumped the tyres to a level that I wanted and I filled every seat with penguins because that is what I wanted to do. I could chose…until I was ambushed by bandits who seized the car and stole it, meaning that it didn’t belong to me anymore. Suddenly they would decide how much petrol went in, how plump the tyres were and how many miles it could run and my opinion was irrelevant (the bandits in this analogy being all the doctors and psychiatrists who recalled me to hospital).
Naturally, having just had my car stolen, I was not best pleased. Thing is, when you ACTUALLY have your car stolen you never tend to see the thieves who are the new owners enjoying a trip around the block in what used to be your very own automobile, and they are unlikely to be very apologetic.

Being in hospital though, I am not only seeing the “thieves” every day, I am living with them, and watching them abuse my car. The doctors and therapists decide what I eat now, when I sit down, where I can go and it is all very hard so I try to talk and work through it with them. I say how scared I am to eat, how scared I am to gain weight, how scared I am of everything and like many people online said last week, they say things like “I am so sorry you are in this position”, “this must be very hard and scary for you” but unlike when people online say it, it makes me angry, and all I can think is “WELL YOU CAN’T BE THAT DAMN SORRY BECAUSE YOU ARE THE ONE DOING ALL THIS. YOU STOLE MY CAR, I AM UPSET ABOUT IT AND CRYING AND NOW YOU ARE SAYING HOW SORRY YOU ARE ABOUT THE SITUATION BUT YOU ARE THE THIEVING, HYPOCRITICAL VAGABOND! VAGABOND I SAY!”

I don’t believe that they can really be sorry because they have what they want, they have the car and are legally allowed to do whatever the hell they want with it. I feel the same way about professionals as I do about close family members like my mum, which I know is terrible and I know I shouldn’t feel that way, yet still as much as I love our visits and I would not be able to get through this place without her, what I get out of them is entertainment, love, company, kindness and knickers (she brings in my clean washing…thanks mum). What I do not want from my mother, is sympathy because in my eyes she is kind of like a thief. Admittedly she did not do the legal act of stealing the car, but she gets something out of it, she now has a say over the car and the thieves will take her views into account. If my mum insists on yellow wheels and the thieves like that idea, those wheels will be the colour of sunshine within 24 hours. She could not have stopped the legal act from taking place but she has more say in it than I think she has used, I am sure if the next of kin kicked up enough of a fuss someone would have to listen, but no fuss has been kicked. On top of that, by me eating and being forced to stay in this hell hole gaining weight, she has benefitted from the thieving.
Again it sounds AWFUL to describe it like that, to compare my mum to someone who is in cahoots with criminals and joyrides around with lemon wheels, when I know she would argue that all she has actually done is not try to stop the people attempting to save the life of her offspring by their actions. She isn’t joyriding (my mum is not a joyful driver…especially if there is a cyclist nearby), she is finally offloading this nightmare she has been living with to professionals who can look after it instead and she can finally sleep rather than stay up into the early hours arguing about sweetcorn. She is benefitting because she gets a break, because as I gain weight she will feel safer and therefore I assume happier yet again, any “I know this is hard and horrible and I am sorry” inspires that same “WELL MAKE THEM GIVE ME THE DAMN CAR BACK AND WHY DID YOU PAINT THE WHEELS YELLOW” rage.

That is why if you were to ask me “how does it feel to have been recalled on your CTO and sectioned back in hospital” I would tell you that it feels like some very apologetic thieves (some of whom are related me), have stolen my car.
Now I am just watching them all make the changes they want, implementing the modifications they have decided, desperate to run out and stop them but with my hands tied. I am just an observer watching people do things to my car, watching things happen to this body that I have had to disconnect from and pretend isn’t mine anymore for my own sanity. I guess a more accurate explanation/analogy then would be to say it is like having your car stolen and then having the thieves force you to be a mechanic carrying out every wish of theirs or risk being whacked on the head by a spanner, but that isn’t how it feels. It feels like things are being done to me, any movements I make are via the puppet strings that they hold, I have no say. When it comes to living with an eating disorder you don’t have much say or control either, but this feels different, this feels more stripped, more naked. This is not my body, it is just a body that I am trapped in, and I am witnessing it be torn to pieces every day. Every meal. Every bite.

CTORecall