The Forgotten People

My original intentions for this blog entry were to post Part-Two of 'Understanding PTSD.'
Part-Two of 'Understanding PTSD' will be the next blog entry to be posted.

But, after an extremely brief stay on a psychiatric ward, this week, from 29th May 2012 to 30th May 2012, I worded a blog post onto my Tumblr blog about what I have called, "The Forgotten People" - a term which I use to refer to those whom have been severely let down by the NHS mental health services after being given a diagnosis of BPD (Bordeline Personality Disorder), which is one of the most highly stigmatised diagnosis's among mental healthcare professionals.

The link to the original Tumblr entry, posted this morning, has been provided within this post. But, I will also re-post the Tumblr post The Forgotten People below, word-for-word. 

The Forgotten People

The Forgotten People

I’m talking about the people who have been Forgotten, or Left Behind by the mental health services; those free services which have been set up to help us, prevent us from hurting ourseleves, and help prevent the breakdown of our mental health.

These are the people whom, like myself, have - in a sense - been “Forgotten.”

People, like myself, who have been bumped from service-to-service in such a way that we have become reluctant to continue engaging with the mental health services.

As I’m sure you may have already suspected, I will be offering myself as an example of one of the Forgotten People.

I feel I have been “Forgotten” - let down - by the mental health services.

I have been under the NHS mental health services from the age of fourteen.

I began my journey with the services with the sunny utopia of the Child and Adolescent Mental Health Services -  where therapy seemed in abundance, and available were all manner of satisfying flavours of talking therapies. A child in a therapy service store…

Hmm… Okay, my metaphor fell flat there, but hopefully you get the gist of what I were, albeit very badly, attempting to say.

As the years have passed the amount of services available for me, have been dwindling, as have the quality of those services available.

As I approach 25-years-of age, many more of those free services, services which offer treatment such as drug counselling, are soon to be cut off from me too.

I have a borderline personality disorder diagnosis and have come to the shocking realisation that no-one is really willing to touch personality disorders as we are viewed as being “Too awkward to deal with.”

Like so many with BPD, I am regarded as a “Trouble maker.”

I’ll admit, I’m by no means an easy person the deal with, but certainly I do not wake up and go out with any intentions of making trouble, whatsoever.


And, I can safely say, that the same goes for the large majority of other people with personality disorder diagnosis’s.

Very recently, I was admitted to hospital (again), staying for the duration of less than 24 hours.

I was admitted in the evening on the 29th May 2012. Then, discharged during the afternoon of 30th May 2012.

The hospital felt that I did not need to be there because, and I use their words, not my own,  ”My bed could have been used for somebody else, someone genuinely ill.”

What?

I am genuinely ill!

Good-grief!

(Don’t worry, the account of this admittance to hospital is relevant to the subject matter of The Forgotten People.)

Okay, admittedly, I put on a “Sane Front” during my very brief stay in hospital; which, in my defence, I did out of, what I felt was, a need to not cause trouble and be regarded as a “Trouble maker.”

Not forgetting to mention the fact that I was not familiar with the hospital I had been admitted to and, probably more importantly, they were not familiar with me. I was taken to a hospital located in an entirely different borough to where I currently live.

I put on a “Sane Front.” 

Meaning; I pretended to be fine, and found myself heavily skewering the truth when speaking to the doctor on the ward, as I did not want to be under their thumb, as it were; as well as using my Sane Front being a way of keeping myself out of trouble.

I put on such a good act that I was were discharged after just one night, not even a full day.

Putting on a Sane Front had backfired on me!

When I was told that I was to be discharged and that  my CPN had spoken to the Ward doctor, I was also informed that my CPN had been contacted and that my CPN would be contacting the Forensic Team, in an attempt to get the help I need.

When discharged and informed of the action my CPN would be taking I felt sorely let down and my anxiety flared - at which point, I removed my clothing, which is something I do to as a way of coping with the claustrophobia of anxiety.

(My coping strategies and mechanisms are not great, to say the least.)

Also, part of me had hoped that behaving this way would make them see how much I need their help; I was unsuccessful, however, and the hospital staff then proceeded to threaten me with police action if I continued refusing to leave hospital grounds.

In regards to my CPN’s plan-of-action; here is the thing, I have already been assessed by the Forensic Team, whom told me that with regret they would be unable to help me as they did not feel their services would be right for me.

When the Forensic Team told me this, I was distraught, as I thought they were fantastic!

I screamed, cried and begged them to take me on, but they told me they could not do that.

The NHS are severely lacking in treatments for borderlines. With the NHS website itself only giving an idea of what treatments should be available, rather than what treatments are actually available.

Which is shocking, especially when you consider that expertise in personality disorders are essential in order to provide treatment. The stigma among mental healthcare professionals against borderlines is far too vast and common.

Personality Disorders are mental health diagnosis’s which need a tentative hand, a person whom is tactful, someone who knows how to remain professional and keep clear boundaries - sadly, this is not something which is available from the NHS for us borderlines.

The mental health services are all too willing to pass the buck; offload their borderline patient onto another healthcare professional; whom will do the same and duly pass their borderline onto another; and this goes on, like a never-ending game of pass-the-parcel.

But my life is not a game, and I am not a parcel.

Even when calling Duty or the Crisis Team, they soon hang up on me due to my bad language, which isn’t directed at them, well, definitely not at first.

My mouth is ”Foul,” expletives do tend to have a way of tumbling from it. I swear when I  am engaged in light conversation, or when online perusing forums, or when watching television, or during the throws of passion.
In short, I swear, a lot.

However, when  I am swearing, generally, it is not aimed at other people.

Some aspects of my disorder are beyond my control, and I often feel as though I am being blamed for my mental illness.

I long for the days of the Child and Adolescent Mental Health services.

The days of current, of putting on a Sane Front, as one of The Forgotten People, are eating away at me.

The wolves are no longer at the gate, they have broken through, and are now devouring my sanity with a furious voraciousness, ripping me apart, tearing me limb-from-limb, and I feel as though I am bleeding onto the snow, struggling to catch my final breath.

At this time, I am screaming out for help, but there is none to be found. So, I feel I have been forgotten.

I feel like a forgotten person. I am one of the Forgotten People.




The Forgotten People:
Original Tumblr post.

Understanding PTSD

The title of this post was going to be ‘Understanding BPD and PTSD’; but, instead, I have decided to go with the more-accurate (in terms of this post’s content) and shorter title of, ‘Understanding PTSD’.

However, as promised, I will still be looking at the “crossover” between PTSD and BPD.

Understanding PTSD (Part-Two)  ~  posted 09/07/2012

The term Post-traumatic stress disorder (PTSD) refers to a range of symptoms which are a response to a traumatic event (or, events) which undermine our sense of safety and security.

(PTSD is also sometimes referred to as PTSS (Post-Traumatic Stress Syndrome.)

Symptoms of PTSD may not appear for some time – weeks, months and, even, years – after the traumatic experiences or event.

and;

Even if you’re not directly involved in a traumatic event, you can still be affected by the event and develop symptoms of PTSD.

It is perfectly natural to be affected by some of these symptoms after a dangerous and/or frightening event. 

Sometimes people are affected by very serious symptoms, which then dissipate within a few weeks – their symptoms could be diagnosed as ASD (Acute Stress Disorder).

When symptoms last for longer than a few weeks, and become an ongoing problem, then they may be the symptoms of PTSD.

and;

It is within the symptoms of PTSD and BPD where the crossover between these two mental health diagnoses’s becomes relevant. 

PTSD causes many symptoms, which can be grouped into three categories; “Re-experiencing symptoms,” “Avoidance symptoms,” and “Hyper-arousal symptoms.”

“Re-experiencing symptoms” includes those symptoms such as, flashbacks - repeatedly reliving the trauma, which can include physical symptoms such as a racing heart or shortness of breath; disturbing dreams; and, upsetting and frightening thoughts.

“Avoidance symptoms,” also known as “Dissociative symptoms,” include symptoms such as, staying away from anything that is a reminder of the traumatic experience; feeling emotionally numb (also known as dissociation); strong feelings of depression, guilt, or anxiety; a loss of interest in activities which were once enjoyable in the past; and, difficulty remembering the traumatic event.

“Hyper-arousal symptoms” includes symptoms such as, being easily startled or “jumpy”; feeling tense or “on edge”; insomnia and/or disturbed sleep pattern; and, angry outbursts.

Those whom have survived a traumatic, and/or near-death, experience tend to prefer to think of themselves as “Survivors” - as opposed to the term “Victim” - due to PTSD being a sign of a mind which has experienced something which has been stretched it beyond the normal human capacity for coping.

Some survivors have objected to the term “disorder” - but the diagnosis recognises the events and experiences, beyond our control, which have a lasting and damaging effect on a person’s mental health.

Initially, trauma tends to cause feelings of “numbness” – a stage which is sometimes referred to as “Being in denial.” 

But, although a person may seem in a state of “denial,” it is likely that on a sub-conscious level they are beginning to process the traumatic experience.

At first, talking about their experiences will most likely be the last thing a person wants to do; and pressuring or forcing a person to talk about their experience before they are ready can be extremely harmful, and increases the likelihood of them developing PTSD.

Different types of traumatic experiences affect people differently; for example, reactions/responses to pro-longed trauma (such as, survivors of repeated abuse), may differ from those whom are survivors of “Single event trauma.”

Responses, or reactions, to trauma differ from person-to-person, and people should be allowed to work through traumas at their own pace.

The symptoms of PTSD are a sign of a person who has seen too much, and whose mind has been stretched beyond the normal capacity for coping.


Understanding PTSD (Part-Two)  ~  posted 09/07/2012

Understanding BPD and Other Personality Disorders (Part Three)

Understanding Borderline Personality Disorder and Other Personality Disorders (Part-Three)

Within this blog post (and throughout this blog-series) I wish to further explore the thought processes, and behaviours, related to BPD (and other personality disorders); and how these relate to our rapidly changing states of mind, feelings and emotions.

(The mental health diagnosis I have been given is that of borderline personality disorder. ~ Nicola Edwards)

                                           

This blog post is a continuation of "Understanding BPD and other personality disorders" Parts One and Two.

One of the recognised symptoms of borderline personality disorder is "identity disturbance" - which is, a significant, and persistently, unstable self-image or sense of self - and is, another large contributing factor towards my own difficulties with communicating and interacting, with other people and the world around me.

"Identity disturbance" is also known as "identity diffusion" (terms which refer to the difficulties a person may have in determining who they are in relation to other people).

Often, I feel as though I am not a real person, I feel as if I am non-existent. 
Like, I'm a work of fiction; an invisible; a ghost.

Identity disturbance can make it hard for people, like myself, to find our place in the world; and difficult for us to identify, or convey, a "consistent" and "stable" personality.

Those with borderline personality disorder often report changing who they are depending on the circumstances and how they believe others want them to behave.
This I can certainly relate to: in most situations I will attempt to "blend in."

Often find I find myself "tailoring" my behavior to suit the circumstances or situation.

I observe the other people around me, and will then imitate them, in order to display behavior which I believe is deemed to be appropriate at that time.

Sometimes, upon observing and imitating others' behavior, their current behavior will seem to contradict past behavior or actions. When this happens, I find myself reassessing the appropriateness of my own behavior and actions.

Although it is true to say that everyone changes their behavior to some extent in different situations, but with BPD this change in behavior tends to be more profound.

Throughout this blog series on BPD, and other personality disorders, I have been referring a lot to the inconsistencies in those of us with borderline personality disorders, in terms of our thoughts, behaviors and actions.

The "definition" of a borderline personality disorder diagnosis is based upon signs of emotional instability, feelings of depression and chronic emptiness.

The inconsistencies and conflicts in thoughts, behaviors and actions - associated with BPD - tend to leave me at odds with myself; often with my own behavior, and actions, working in spite of myself.

For example:

• Within my relationship with my parents.

Despite being in my twenties and living alone in independent accommodation, I'm still very dependent on my parents (I spend a lot of time with them, and they often help me out with day-to-day chores).

However, I also often feel "crowded" by them and feel that they are working against me.

I thoroughly enjoy my independence, but also long to be "looked after", or "cared for" by another person.

• My thoughts and actions work in spite of myself in a similar way in terms of "Isolation vs. Socialising."

I go through periods of self-isolation - in other words cutting myself off from everyone. But, even during these periods of self-isolation, I become depressed due to extreme feelings of loneliness.

• Within my relationship with my friends.

When I meet someone whose company I truly enjoy and feel comfortable with; I form "intense" relationships with that person, which can sometimes make my company feel quite demanding.

I focus on those relationships which I have "favouritised", which can cause myself to become partly-dependent upon that particular friend. This may include behaviors such as calling a friend for support at "unreasonable hours" (ie. late-night/early-morning phone-calls).

• Within "sexual" and/or "romantic" type relationships.

My present feelings and ideas towards all relationships will be rooted in, and based upon, past experiences.

The abusive nature of most of my past "sexual" and "romantic" experiences, means that my present and current ideas towards those types of relationships are very "mixed-up"

I feel confusion and fear towards these sorts of relationships.

Due to past experiences I devalue myself in order to feel approval. I tend to distrust all those whom I "fall" for, I believe that they will use my feelings towards them against me as a form of control and abuse.

....

Understanding the "identity disturbance" in a borderline personality disorder diagnosis can help to understand the inconsistencies and conflicts in our thoughts, feelings, behaviors, and actions.
Understanding "identity disturbance" can help to understand why those of us with the diagnosis behave the way we do.

The next part of this blog series will be titled, "Understanding BPD and PTSD" -where I will look at the crossover between a borderline personality disorder diagnosis and a post-traumatic stress disorder diagnosis.

Related previous blog posts:

'Understanding BPD and other personality disorders (Part One)' ~ April 2012

'Understanding BPD and other personality disorders (Part Two)' ~ April 2012

'What is BPD?' ~ August 2010