The Stigma Of Treatment

All the important people in my life know I struggle with my mental health. That’s old news. I’m not even overly anxious about sharing some of my struggles with the right people at the right time.

On the other hand sharing what treatment I’m receiving for my mental health is so much more anxiety provoking and worrisome.

I’m on three psychotropic drugs, and there’s plenty of judgement and stigma from people about that. I need these medications to function, if anyone has a problem with that, they can get lost.

I’m seeing a therapist weekly. At this point in time the therapist is a psychiatrist. In the past they’ve been psychologists, clinical psychologists, and counsellors. Therapy is a really good way to help me manage my mental health. Again, if people have a problem with that, they can get lost.

Then there’s the inpatient psychiatric admissions. Five in the last two years. Most of them for about three weeks. Not all in times of crisis, but of great stress, and with multiple crappy coping strategies being used.

I’m heading for my seventh admission with the same doctor at the same hospital. I trust my doctor, and I trust the nursing staff. I know the admission will be helpful, they always are, but I’m scared to tell anyone.

I worry so much more about what people might think about me being in a psychiatric hospital, than being on medication, or in therapy.

Is it really that bad that I need to be in hospital?
Yes. Doing the same amount of work in therapy outpatient is impossible. Plus I’m stuck, again. DID chaos, and multiple shit storms brewing beneath the surface. That doesn’t even cover the issues I’ve had with mood (both hypomania and depression in the last month). It is that bad.

Can’t I just get over it? Isn’t therapy enough? Can’t they give you medication?
I’m doing the therapy, and taking the meds. I’m still struggling. As for getting over it? Get lost.

I know hospital is a safe place to crash land. I can be a mess, be emotional, struggle in any kind of way and it’s okay. I don’t have to keep it together. I don’t have to keep smiling. Staff are kind and supportive. I have time and space to unleash the chaos, work through it, and put myself back together again.

I’ve still only told a few people. I’m so fearful of their reaction to, and judgement of inpatient treatment that I stay silent.

I think the stigma associated with psychiatric or psychological treatment can often be so much worse than the stigma associated with a diagnosis.

It’s okay to not be okay, and it’s even more okay to get whatever help you need to be okay again.

‘Oh, just PTSD stuff.’

‘Oh, just PTSD stuff.’ That’s how I brushed off the need for my recent psychiatric hospital admission to a work colleague.

I’m disappointed that I felt the need to minimise how much I was struggling, but there’s also only so much that’s appropriate to explain in the workplace. I gave my manager even less information. I just said that I needed to go into hospital and would need two to four weeks off work. No questions were asked, and for that I’m grateful.

How was I to explain that I have a generally unknown mental health condition, and that I was struggling to cope with an increase in symptoms? At work it’s not appropriate, and not necessary. I was more honest with one colleague because I’ve known them a long time.

The real reason for my most recent hospital admission? DID chaos. I was having more flashbacks, anxiety was increasing, and I was doing everything I could to isolate myself from everyone inside and their feelings and memories. I also had trauma anniversaries rapidly approaching, and a lot of anxiety about those. All of that anxiety and stress meant falling asleep at night was becoming increasingly difficult.

I’d made an appointment with my psychiatrist, at the urging of my then psychologist (she’s since retired), to discuss a hospital admission. I didn’t think things were too bad. I was still functioning, even if I was struggling a lot. Throw in a severe dissociative episode in the days before seeing my psychiatrist and I stopped fighting. I willingly agreed to the hospital admission.

 

Returning

We’ve been quiet again for a little while. Internal chaos was building, flashbacks increasing, and my ability to cope was fading.

I spent a few weeks in hospital doing some of the most intense therapy I’ve ever done. Really, truly addressing the trauma we’ve experienced. There were tears, plenty of zoning out, but ultimately triumph.

Trigger words are no longer so triggering. They’re sensitive and painful, but no longer triggering. I can use these words to describe the trauma we experienced instead of doing everything I can to avoid it.

We managed to do a lot of work with different parts. There’s still plenty of work left to do with different parts, but we did a lot.

Now we’re home we’re taking time to adjust to life at home. It will take time to get used to having our freedom. Once we’ve settled back in to day-to-day life I’ll try to write more regularly.

Social Anxiety

Social Anxiety.

This is what happens when a friend visits me at home. It could be someone I’ve known for a few years or close to ten. Let’s say that this friend said they’d be at my house between 1pm and 2pm.

11am
They said they’d be here between 1pm and 2pm. I need to tidy. What if they’re late? What if they forget? Or if they come early? What do I say to them? What if we have nothing to talk about and it’s awkward?

12pm
One hour until they get here. Maybe. It could be two hours, but I have to be ready in one hour. I need to be dressed, brush my hair, look nice. What if they forget? Did I give them the right address? What if they go to the wrong house? I’ll watch TV to distract myself. Oh, but I need to make sure the house is tidy.

12:30pm
I think I’m ready. What if they forget? I need to check what time they said they’d come. Oh, and I’ll double check the address. What if I’ve given them the wrong address? Maybe I’ll get comfy on the couch. Then I can see people coming. Then the doorbell won’t make me jump.

12:50pm
They’re not here yet. They’re not early. It could still be an hour before they get here. I’m not comfortable on the couch. I’m exhausted and hot and want to rest in bed. What do I say to them? What if we have nothing to talk about? What will they think of me? They’ll see how horrible I look. They’ll hate me.

1:10pm
They’re not here yet. What if they’ve forgotten? What if something bad happened to them? Should I message them to check they’re still coming? I’ll make sure I gave them the right address. Oh, and what time did they say? Maybe I got the time wrong. Or the day. What day did they say they were coming?

1:25pm
Friend arrives.
Thank goodness they’re here. Oh, what do I say? They’re looking at me. What do they think?

1:35pm
Friend leaves.

1:36pm
Oh thank goodness they’re gone. It was nice to see them. They seem to like me. I think it went okay.

1:38pm
I hate myself. I hate my size and my shape. I’m sure my friend noticed. I’m such a horrible person. I wish I didn’t get so anxious. People are nice to me. They seem to like me. I make conversation easily. I still hate it. I wish I didn’t have to see people. Except that I get lonely, and I like spending time with people.

1:40pm
I’m useless. I get anxious over nothing. This is all so silly. I don’t know why I care so much. My friends seem to like me. No one makes them spend time with me or do nice things for me. I don’t know why anyone likes me. I hope I don’t have to talk to anyone else today.

 

As much as I enjoy seeing friends and interacting with them, the whole process can be incredibly draining. The anxiety and worry is the same for almost any social situation.

It’s something I’m working on, and something that’s going to take time to address. Awareness helps, but it’s only the start. Changing the thinking and making longterm change is the next part. That’s where I’m at right now. Still working on it.

 

The Monotony of Self-care

Eating, drinking, showering, cleaning teeth, brushing hair. That’s self-care, right?

It is, but there’s so much more to self-care than the short list above. Self-care is everything I need to do to stay well. Some of that will cross over into specific relapse prevention techniques, but I’ve found that thinking of it as self-care is more helpful.

My days include basics like eating, drinking, bathing, and sleeping, but there’s much more to it than that. There’s daily medication, then PRN medication to help manage varying mental health symptoms, as well as managing ME/CFS symptoms and flare ups.

I usually have one major task to complete each day that brings a sense of success and achievement. That could be work (retail cashier), a small gardening project, a household chore, or an outing (eg. a friend taking me grocery shopping, or going to a healthcare appointment).

On top of all that I try to do at least one thing each day that brings me joy or pleasure. What that activity is can vary greatly. There’s creative projects (eg. knitting, painting, colouring in, sewing), gardening, taking photos of the birds that visit the birdbath in my courtyard, watching a movie, taking an epsom salt bath etc. It’s a limitless list!

In between each activity there’s rest. Lying down to help ease pain or changing from a high energy activity (eg. household chores) to a quieter activity like watching a movie or TV show on my laptop. Resting so often, and so much is how I carefully manage ME/CFS symptoms.

My final activity most days is journalling. I turn my laptop, and the TV off. I turn a small lamp on in my bedroom, and turn off the main light. Then I get all our journalling supplies (we each have our own pen to write with) and our journal and get started. I write everything that comes to mind. I let my thoughts wander and write whatever comes. I checkin with everyone and we, as a group (a committee!) discuss whatever comes up.

I usually take bedtime medications that make me drowsy halfway through journalling. By the time we’re done writing we’re sleepy, relaxed, and ready to sleep.

This, all of this, is self-care. Every single day. Over, and over, and over. This is part of staying well.

What do you do to take care of yourself?