Tuesday, March 22, 2016

7 Practical Ways to Help

I decided that I should create a list of practical things people can do to help me and others who are struggling with depression or who may be hospitalized for their mental illness.

1) Be there.
This would seem to be so obvious to some people but it's something so many people forget. This can be done in a variety of ways. If I am in the hospital, come visit me if you can. If you can't, call me or write me a letter or even send a card. It seems so simple but it makes such a huge difference. If I am just struggling with depression overall, don't just assume I know you are there for me. Depression clouds my thinking and my viewpoint and makes me think that I am being a burden to whoever I reach out to. So being there for me may mean reminding me that you are there if I need to talk. It may be actually calling me and asking me how I'm doing if you notice I'm struggling. It may be coming over and watching a movie with me. Just being there is what is most important. Another part of being there is staying with me if I do feel like harming myself. If the urge to harm myself is serious enough, sometimes I need someone to be in my apartment with me to keep me safe until the urge passes or until I go see a professional.

2) Help with household tasks
One thing I really struggle with when I'm in a deep depression is house cleaning. I have no energy to clean and therefore I don't so my apartment gets messy. I also have no energy to do laundry either. Another thing I have trouble doing is cooking or preparing meals for myself when I am depressed. Sometimes even putting something in the microwave is all I can do. Offering to help with my animals is another way you can help me when I am struggling with depression. When I am in the hospital, this is even more important. I need someone who can look after my animals. I need someone who can provide meals the first few days home as I may not have the energy to do it. I need someone to help me keep my apartment clean and my laundry done once I leave the hospital.

3) Prayer
This is something that those who pray can do to help me. Knowing people are praying for me is a huge comfort.

4) Logistics
One of the hardest things when it comes to being hospitalized is dealing with things like transportation to and from the hospital as well as getting me the things I need for while I'm in the hospital. This may mean I need someone to go to my apartment and pack me a suitcase if I do end up needing to be hospitalized and it's an emergency. I may need rides home from the hospital or even rides to the hospital. If something serious happens in my depression and I need to be taken to an ER to be checked out, it is much easier having someone take me there than it is going in with EMS. EMS just increases my anxiety and is an additional expense that sometimes insurance doesn't cover. This means I need people who are willing to drive me to the ER if I do something like cut myself too deep or am at a high risk of harming myself. 

5) Financially
Now I understand this is not something that everyone can do and no one can do it all the time. I totally understand that. But even if it's just a couple dollars here or there to help me cover bills I have no way to pay. I cannot say enough about how much stress has been relieved when people have offered to help financially. Life continues to move on even if I am in the hospital or so depressed I can't get out of bed to go to work and bills continue to come.

6) Random acts of kindness
Now this kind of ties in to some of the other things listed above. But this can be a letter in my mailbox, a random text or email or a Facebook message. Sometimes when I'm depressed I don't like answering the phone and texting is easier for me to communicate through than over the phone. This could also be taking me to lunch or anything outside of the house if I'm having a hard time leaving the house by myself. And if the depression is too bad for me to leave the house at all, showing up with some ice cream and a movie is an easy way to help me out and make me feel like you care.

7) Education
Now this is a HUGE one. So many people don't understand mental illness and what it's like to deal with depression and suicidal thoughts or what cutting is and why I do it and things like that. So being willing to ask questions about the disorders I struggle with to try to gain understanding and insight is one way that people show me that they care. Education could also mean doing some quick research on the web about the different things I struggle with. There are SO many articles out there that explain what it's like to live with mental illness and ways to help. I personally love it when my friends ask questions. I love it when people say "I've read this article, how is this related to what you go through?" I would much rather people ask questions then assume they know the answers and pass judgment (even when they don't realize it). Another part of education is having an open mind about the subject in general. I have met many people who are unwilling to learn about mental illness and in doing so make comments that hurt me and push me away. Having an open mind and wanting to understand is a great way to help me.

Overall, these 7 things include something that everyone can do to help those who have a mental illness during the difficult times. I know there have been times where I wouldn't have made it without the support of others around me. Many people ask me how they can help and I don't always have an answer for them because it is difficult to ask for help and admit that I'm struggling. So be willing to reach out and extend a helping hand even if it's something small. It makes a world of difference.

Thursday, March 17, 2016

Self harm and the past 48 hours

******trigger warning*******
So I have had a very interesting two days to say the least. Tuesday I worked 8-5 and then I tutored 5:30-8pm. On my way home I stopped for gas and some groceries and went home after that. I didn't get home until about 9pm. I checked on my animals and made sure they were all okay and then proceeded to the bathroom. While in the bathroom, I contemplated cutting, or self harm (something I have struggled with since I was 15).
With cutting, I go through periods of time without doing it and periods of time where I do it often. There really isn't an in-between. The middle of last week was when this period of cutting started. The first time I cut it was deep, but not that deep. I did it because I had hit a car in the parking lot and felt like a horrible person about it. I was worried about paying the deductible and how things were going to work out and my emotions were running rampant. The thing with my BPD is that when I feel any negative emotion I feel it intensely, like 100 times what someone without BPD would feel. So I self-harmed. The next day, I went to minute clinic and they put steri-strips on it and it was no big deal. This past Sunday I cut again, except it was much deeper. I was exhausted and had been struggling with thoughts of self-harm and suicide throughout the day. They came on for really no reason at all. And again, when I felt the negative emotions that suddenly came over me, it was extremely intense. I felt out of control of the world around me so I self-harmed. I bandaged it but after my experience with minute clinic wasn't sure whether or not it needed stitches so I decided not to go get it checked. I thought about it but never went. I learned later that I should have.
Then Tuesday night, after I got home, I sat in the bathroom for a decent period of time. I even wrote a dark poem to try to help convince myself not to self-harm. It didn't help. So I self harmed. I did one cut across my right forearm and the moment I did it, I gasped. I had cut really deep unintentionally and it was pouring blood. I covered it with gauze and as I looked at it, I knew it needed stitches. So I called EMS. BIG MISTAKE!!!!!!!!!!! The person from EMS over the phone told me what to do to stop the bleeding and I followed his instructions and he ended the call. Then less than 2 minutes later, I got a call from the sheriff's office, or first responders. They were asking about what had happened and I told them. Their first question was "was this a suicide attempt?" and I said no. The lady asked me to stay on the phone with her until the people arrived (I guess to make sure I didn't try to hurt myself further, which wasn't even on my mind at this point). The cops arrived first. There were 3 of them. I don't understand why it was necessary to send 3 police officers to my apartment for a self-harm cut. Once the police officers arrived, one immediately recognized me from my attempt back in October. I didn't recognize him. Another guy didn't say hardly anything. The last police officer I guess was the lead guy for the 3. He took my information down (I'm not sure of the reason) and commented on my animals. He took a picture of my bunnies and was talking about my animals. I had some poop on the floor (from my dogs who are left inside all day while I'm at work) and my kitchen was a little messy and the third officer just had to make the comment that the way I am living "wasn't healthy" and that he could report my living conditions to animal control and they would take no mercy on me and would take all my animals away. Considering the circumstances, I don't think this was necessary nor appropriate. I had just harmed myself and was obviously not in the best state of mind yet he threatened me. This just showed me how untrained police officers are when it comes to handling people who have harmed themselves and who have an obvious mental illness. This is a major problem with society. They do not know or understand mental illness and therefore treat the people who are struggling poorly with no compassion. 
Once the EMS people got there, they looked at my cut and asked me what happened. I told them, they wrapped the cut in some gauze, said I would need stitches and then I followed them out of my apartment. The police officers left and I walked to the ambulance. The EMS people were all helpful, caring and compassionate. They didn't see me as someone crazy. They wanted to understand what was going on. They treated me like they would a normal patient. I enjoyed my ambulance ride to the hospital, specifically because of them. I even laughed a couple of times with them. Then we arrived at the hospital.
The hospital they had taken me to is one I have been to many many times. Greenville memorial hospital. They handle most of the psychiatric cases for Greenville county and almost all psychiatric calls are sent to them. They have the largest section of the ER designated for psych patients. The problem with this though is that many of the staff are ignorant, rude and obviously don't care about the patient. If someone is suffering so much that they end up hurting themselves or want to hurt themselves, compassion is the FIRST thing that should be offered, NOT judgment! So they wheeled me over to the section of the ER designated for psych patients, helped me off the stretcher and put me in a chair because there were no beds or rooms available. The first person to interact with me was a tech. She came to draw my blood and ask for a urine sample (this is standard procedure). She was rude and uneducated. She tried to argue with me about what I did to myself. She said things like "we take these things very seriously here" and "we consider what you did a suicide attempt" and I tried to explain to her that it was not a suicide attempt, just self harm. Self harm is used to help me survive and handle life. Suicide attempts are me trying to escape life. BIG difference. She obviously didn't know that. She just assumed I would be committed to a psych hospital on involuntary papers and that would be it. I tried to advocate for myself and she wasn't having it. The nurse on duty that night was actually fairly sweet and kind to me the entire time I was there, which I really appreciated.
As the night progressed, I was really bothered by a variety of things. Two different people were put in restraints for being un-cooperative and it seemed like that was not necessary for the situations that were occurring. Some patients were screaming and were rude to everyone and it was chaos for a period of time. Once it calmed down, the charge nurse came to me and apologized for the mess and asked if I was okay. I told her I was anxious because of what happened but was fine otherwise. She ended up making a joke that it was "free TV". Other staff repeatedly talked negatively about patients and laughed at them, in places where the patients could hear them. This really bothered me. They are people too. They didn't choose this illness. It is something that happened to them! The stigma attached to mental illness runs rampant in the one place that should be the most understanding of all, the hospital. If people are brought in by their loved ones who are concerned for them or if they bring themselves in, they should be treated with the utmost respect. Other patients in the hospital aren't made fun of for their illnesses. Staff doesn't joke about them. It's only the psych patients. This is the problem. If people are going to be laughed at and judged when they reach out for help, they are less likely to seek out help. I know for me, there are many times I have either attempted to end my life or self-harmed and not sought out help because I knew how poorly I was going to be treated and wasn't going to subject myself to that.
Anyways, the night continued on and I waited and waited and waited to be seen by a doctor. Finally, a nurse practitioner came around with a social worker and looked at my cut. They asked me a question I had already been asked at least 5 times - was this a suicide attempt? No it was not. Part of me wanted to look at them and tell them that if I had been trying to end my life, I would not be cutting myself. If I was trying to end my life and failed, I would be unconscious and would have to be dragged there. They also asked me many times who called EMS. I did. They were shocked by that. The social worker asked a couple questions further and then left. The nurse practitioner told me that I would need stitches and that she would be back soon to stitch me up. She also determined then that she would want me to be evaluated by a psychiatrist. So they found me a bed and put it in the hallway. The nurse practitioner came and stitched up my cut. 7 stitches in my arm. She also commented that my cut that I had done Sunday night should have also been stitched up but it was too old now to do that. She was nice the whole time and asked me questions and we had a good conversation. She ordered my medications and gave them to me as I would normally take them at home, which has never happened in any of my experiences at the ER or even in the hospital. Staff continued to make fun of patients into the wee hours of the night. I slept off and on but didn't get too much sleep. Thankfully they allowed me to keep my stuff which doesn't usually happen and this helped me sleep. In the morning they gave me breakfast. I saw 2 more social workers, another nurse practitioner and then was interviewed by 2 psychiatrists and a med student observed. After all of this, they determined that I could go home. I went in around 11pm Tuesday night, was not stitched up until 3:30am and did not get discharged until after 2pm.
Overall though, the sad thing is that this was my best experience with that ER to date. Most of the staff were kind and compassionate, to me at least. They got me what I needed and handled the situation appropriately. There were other patients there that weren't as lucky. Many were made fun of, laughed at and talked rudely to for no reason. I was glad to leave when I did. I was also glad they did not try to commit me to a psych hospital. It was an overall interesting experience, but one that saddens me. There needs to be more training for first responders, police and hospital staff about psychiatric illnesses and how they should be handled and how people should be treated. If this meant an extra course in college or a yearly training, it would be so worth it and would make a huge difference to the patients. Attitudes toward mental illness need to change. People deserve help and shouldn't have to go through unnecessary suffering to get it.
As of now, I'm still in a very unstable position. Thoughts of self-harm are intense and almost constant and I'm having a hard time fighting them off. I think about reopening cuts, including the one with stitches. I know it sounds horrible but it is the struggle of my life right now. I'm doing all I can to hold on, but at times it doesn't feel like there is anything to hold on to. I go to the psychiatrist next week and hope that maybe through that I can get some help and maybe some medication changes to help the thoughts in my head. It's been a rough 48 hours but I have survived. I know now what to do if that situation were ever to occur again and will hopefully be able to avoid all of this mess in the future.

Monday, March 7, 2016

My Written Response to many comments.....

I am writing this post not to single people out or attack people and I don't intend on naming names or organizations or books or anything like that. There is just a lot on my mind that I need to write out for others to read and see. Hopefully this will be educational and help people understand where I come from.
In the past several months, I have heard and received many comments from people, more so from Christians than anything else. These comments and remarks generally show a lack of knowledge in general about mental illness and while not intended to be are hurtful and frustrating for me to receive. So in this post I will go over a number of comments I have received and my personal responses to them that aim to educate those who may have made them in the past and those who may make them in the future. While I don't claim to be an expert on being a Christian or on mental illness in general, I am an expert on my own mental illness.
The first comment I will go over is one that can be stated in many forms. These can include things like "you just need to pray more" or "you just need to read your Bible more" or "you need to do a bible study on your problem and have God lead you to the solution". All of these ignore multiple pieces of information. The first is that mental illness is a physical disorder characterized by physical changes in the brain. Yes it is a brain disorder, a mental disorder, AKA a disease of the brain. This makes it just as real as cancer, heart disease, diabetes. I have never heard anyone go to someone who has cancer or diabetes and tell them "you just need to ______ more" as if it is a total solution to the problem. I am not discrediting the fact that bible study, bible reading and prayer can all be helpful things in the process of dealing with any illness or injury. BUT this does not mean that there are other things that are part of the process in dealing with mental illness.
The second comment I have received is that I just need to forgive and all my problems will go away. This can also be accompanied by comments like "you are holding on to the past and the hurt and by forgiving you can just move on". Again, forgiveness is something that needs to happen eventually and is part of the healing process. However, to state that forgiveness solves all problems ignores the reality that is Post Traumatic Stress Disorder. Again, this is a physical change in the brain where the brain is put on high alert constantly and is always in the flight/fight/freeze mode. This is absolutely and completely exhausting! PTSD includes hypervigilance related to the flight/fight/freeze response, flashbacks, nightmares, memories, all of which are NOT chosen. I do not choose to have this. It is a physical change in my brain due to toxic stress I went through while I was growing up. My brain developed differently because of the environment I grew up in. This is not something I chose, nor something I can control. Forgiveness can help the process but when you are reminded of the hurt over and over again not by your choice it is an ongoing and exhausting process and one that not everybody is ready to take on right away.
The third comment is related to the first. It's the comment of "just trust God and you won't have anxiety". Again anxiety is a physical response to stimuli in the environment or even to nothing at all. I cannot choose if and when I have a panic attack. I cannot choose whether my brain runs on overdrive. Sometimes my panic attacks will come out of nowhere and sometimes they have a trigger. Trusting God is something that everyone needs to do in their life. However, this does not eliminate the physical reaction that is anxiety.
The fourth comment is one that really bothers me. This is one where it says things like "suicidal thoughts are a sin" or even "mental illness is based on some sin you have in your life". This means that mental illness and suicidal thoughts are a choice. I am here to say that they are NOT. I don't choose to think the way I do. If I could choose to not have the thoughts, trust me I would. If I could choose to not have a mental illness, trust me I would. Suicidal thoughts are something I can choose to act on or choose not to act on. Sometimes the thoughts are so strong it takes everything I have in me to keep myself safe from harm. Sometimes the thoughts are just passing, needing to be acknowledged that they are there and then moved on from. I have learned how to deal with them the best I can. But this is not something I chose.
The next comment is "if you only have enough faith in God, He will heal you" or something similar. God can choose to heal me just like He has chosen to allow this in my life. I believe that God can heal me but I also believe that He is sovereign and has total control of my life and everything else in the universe and that means that He can choose to heal me or He can choose not to. He has a reason that this is in my life and He has promised He will use this for good.
Comment number 6 is something along the lines of "why don't you try God's way instead of man's way" and this comment usually refers to the use of psychiatric medications and therapy. There are many that believe that using psychiatric medications is wrong and that the only therapy that Christians should ever receive is biblical or pastoral counseling. Again this is not to discredit biblical or pastoral counseling. But people with severe mental illnesses need people with certifications and understandings of the mental illnesses and what therapies are good to treat them. These include trainings in therapies like cognitive behavioral therapy, dialectical behavioral therapy or EMDR. All of these therapies require special training and certifications and many biblical and pastoral counselors lack these certifications. God has allowed medicine to be created to be used to help people. Telling people not to take their psychiatric medication is just like telling people not to take chemo for cancer or insulin for diabetes. If it weren't for the medication I am currently on, I would not be a functional human being. I would be confined to my house, to my room, to my bed. I would have constant anxiety and depression with no relief. My medications are NOT a total fix and are not "happy pills" as many may think. My medications make my life work and make me a productive person. The therapies I go through are far from easy but are specifically designed for my mental illnesses and help me to deal with the struggles that come with the illnesses. They help me learn to cope and handle life's challenges which I can't do like people without mental illness because of the physical changes in my brain. So instead of viewing medication and therapy as man's way, let's recognize it for what it is - a provision from God that allows people with mental illness to get the help they need.
The last comment I will go over is one that isn't really related to Christianity but is one that I have heard many times. This comment is one where people state that I will "grow out of" my mental illness and that it's just a part of adolescence. Again, going back to my first point. Mental illness is a physical change in my brain and is not something I will grow out of. It is something that with the right treatment and hard work in therapy, I may be able to learn to live with and not have it be completely debilitating but it is not something I will simply grow out of.

To close this post, I am going to review what Chonda Pierce said at the event I saw her at this past Friday. She shared her experience in a psychiatric hospital in group therapy. Everyone was given their chance to share why they were there, how they were feeling and any struggles they wanted to talk about. Once they were finished, the response was "thank you for sharing". Her comment was "Isn't this what the church is supposed to look like?" where we thank people for telling us their struggles and hardships and accepting them for what they are and then thanking them for being open about it. We as Christians are to care for the brokenhearted, not fix them. So let's learn about mental illness and make sure what we say is helpful, not hurtful and takes into consideration the reality of the physical component as well as the mental, emotional and spiritual components of mental illness.