Poems

12/09/16 Poem
What's the point in all this?
Nothing matters.
It all leads to a sea of misery
Where waves crash hard
And storms rain down
Lightning keeps flashing
Thunder keeps rolling

Were is the break in the clouds?
The sunrise
The dawn?
Where are the clear skies that show
The new day has come?

Can we not have just 1 ray of
Sunlight today?
Or is it just gray?
Will it always be that way?

Or maybe there will be a
Break in the clouds
Just enough for us to think
Hope has been found?
For us to take a breath,
Dream a new dream
Create new things the
World has never seen

But the break never sticks around
Hope doesn't last
Dreams are broken once again
And new ideas are thrown to the trash

The sun never hangs about
The clouds come back to play
The storms are my worst nightmare
As they take my life away

Piece by piece I lose myself
To the waters of the sea
Maybe someday it will wash to shore
And reach eternity

Maybe one day I'll pass on
As pieces here and there
Put together in eternity
With my Creator there

Until then I'll fall apart
Riding each new wave
Until my mind or body gives up
And sends me to the grave

Each storm will take a piece of me
I'll never be made whole
There really is no point of this
No point to stick around

The waves keep crashing
The sun keeps hiding
The sea keeps moving
To a life of misery
Maybe one day it will swallow me whole

12/10/16 Poem
I'm sinking with no life vest
Down into the deep dark sea
Who will come to my rescue
Does anybody hear me?

I've been holding on so tight
To what I thought was hope
But now it's stripped away again
And left me with some rope

Some rope to tie around my neck
Just hoping it will break
And end all of this craziness
Just for Heaven's sake

Give this world a rest at last
For their burden will be gone
There will not be anymore of me
To continue to lead them on

A break for the world
For my deep pain
Is long overdue
And I'll be swimming with the fishes
In a sea of ocean blue

My soul will finally be at home
In the dark blue sea
The drowning will be over
As will the misery
There will be no tears to
Cry, nor pain to feel at last
Cause finally my body
Will be at rest with the past

Sitting in the dirt thinking of
A dream I once thought I had
Wishing on stars I once thought
I could see
Then reality comes to my eyes
There were no stars, there were no dreams
Just broken hearts
Crying eyes
Missing pieces from a fractured life

Empty promises
Painted faces
And a lot of lies
That's when I realized
There's no point in this life

So why go on when all you see
Is destruction and misery?
Why press on if all that's there
Is another lie and an empty chair?
Why keep pushing to the end
When all that's there is another bend?
What's the point?
This just doesn't seem right

Let this world just move on
Let her just be gone
The world would be better anyway
So let her go on her way
Swim with the fishes in a new day
No more drowning, no more pain
Just a new freedom

Move on now, just like before
She doesn't even matter anymore
Life goes on like it did
Soon enough you'll forget what she did

And life will be what it was
It will continue on like before
People come and people go
Just like the ones you used to know
Life keeps going good and bad
It'll keep moving happy and sad
We all just have to deal with the mad!

College and Borderline Personality Disorder

College is a time of life that is one of self-discovery and self-definition. It is a time where people make friends that last them a lifetime and oftentimes meet the person that they will one day marry. College is filled with so many new experiences from college parties, fraternities/sororities, more difficult classes, and a whole lot more independence. What usually accompanies all of these things? Stress, and lots of it. College can be the best time of someone's life.
But for someone who has Borderline Personality Disorder or BPD, college can be a tumultuous time of their life. Borderline Personality Disorder is defined in the DSM as "a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity, beginning in early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

1. Frantic efforts to avoid real or imagined abandonment
2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation
3. Identity disturbance: markedly and persistently unstable self-image or sense of self
4. Impulsivity in at least two areas that are potentially self-damaging (e.g., substance abuse, binge eating, and reckless driving)
5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior
6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)
7. Chronic feelings of emptiness
8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)
9. Transient, stress-related paranoid ideation or severe dissociative symptoms"

Borderline personality disorder generally has traits that appear during adolescence but the actual diagnosis cannot be made until someone reaches the age of 18, which usually is the age of a college age student.
One thing to keep in mind with the diagnosis with BPD is that someone needs to have 5 of the 9 symptoms to be diagnosed. There are a total of 256 combinations of the symptoms that can be present for the diagnosis to be made so all of the following suggestions may not be applicable to every person with BPD.

What does this mean for a college student struggling with BPD?
1) Relationships look different. This is the hallmark of BPD. For some, it is easy to make friends while for others it is difficult to make friends. For almost all, it is extremely difficult to keep friends. Relationships are extremely rocky in nature because of the kind of thinking that comes with it and the patterns that follow the thinking. One characteristic thinking pattern is all-or-nothing thinking also known as black or white thinking. This includes the extremes of idealization and devaluation. This means that one day someone can be put on a pedestal and the moment they do something wrong, they are the worst person ever. Another way this may happen is that when someone is in the idealization stage, all faults may be overlooked until something becomes so obvious that it cannot be and the flip to devaluation occurs. It may also occur with devaluation. Someone may view someone in such a negative light that nothing positive that they do can change the way they view them. What this leads to is tumultuous relationships. Tumultuous relationships can add extra stress to those who struggle with BPD, making college even more stressful. However, they crave human connection and need it.
2) Self-image related situations. People who have BPD struggle with maintaining a stable self-image or sense of self. This can mean that college students frequently change majors as their interests change frequently as their sense of self changes. For example, one semester they may study education because they want to be a teacher. Then they decide they want to study business. Then they decide they want to be a writer. The frequent change of majors is often related to the fact that they don't know what they are truly interested in and don't have a stable sense of who they really are. Another aspect of self-image related situations is perfectionism or apathy. Again, it is usually in extremes. They can be either perfectionistic, high achievers in their studies and do exceedingly well, or be apathetic and have poor performance. They can also go back and forth between the two.
3) They have to be careful. One symptom of BPD is impulsivity. This can include substance abuse (including alcohol and drugs), over-spending, driving recklessly, or being promiscuous. While it may be okay for some to have a few drinks every now and again, some people who have BPD cannot do that. It can lead to a pattern of impulsivity that can become dangerous quickly.
4) They need extra support. This is the most important. Getting treatment for BPD is so important and the earlier the treatment begins, the better. Having support from peers is critical to making it through college and being successful. It is also sometimes a key aspect in getting treatment. Many times students with BPD are afraid to seek treatment because of the stigma out there that exists but are more inclined to go if someone goes with them.

So what can you do as a college student or a college professor who knows someone struggling with BPD?
1) Offer support. This can come in a variety of ways. This can mean going out to lunch or coffee with them. This can mean getting together to study with them. This can mean just lending a listening ear when they are struggling.
2) Offer to go with them when they do seek treatment. This can be critical to them feeling more comfortable when it comes to seeking treatment and following through with treatment.
3) Be consistent. This is probably the most important thing when connecting with someone who has BPD. Part of having BPD means intense fear of real or imagined abandonment and if someone is not consistent in their relationship, it can be mistaken as abandonment which can lead to catastrophic consequences. This does not mean it is not all on one person either. It does not mean being there every moment of every day. It just means not randomly dropping out for periods of time without letting them know what is going on.
4) Take care of yourself. There is the saying on airplanes that one must "put on your own oxygen mask before helping someone else". This applies to life in many ways. You must take care of yourself and not run yourself down into the ground to help someone else because it will only make the situation worse. So make sure your oxygen mask is on first.

Again, please note that all of these do not apply to every person with BPD as no one with BPD looks the same.
The one thing that should be kept in mind through all of this: There is hope, no matter the diagnosis or the situation and help is available after a diagnosis.
Overall, BPD can make college more difficult and more complicated, but it does not have to take away the rewarding experience that it can be. College can be a fun and exciting period in life for anybody. It can be a challenging experience for anybody. The same applies for people with BPD.

The Reality of Psychiatric Hospitals Part 1

Many people do not understand the realities of staying in a psychiatric hospital. Many do not understand what goes on inside a psychiatric hospital and how challenging those stays can be. I've even known people to refer to my hospitalizations as "vacations" because that's how they saw them when they are the furthest thing from that. This may be a long piece that I may have to break up in segments but here is a start.

Being admitted to a psychiatric hospital:
This can be done in 2 ways. The first is through the ER or medical hospital. The second is done directly through the psychiatric hospital. I have done both and have very different experiences with both.

Being admitted through the hospital directly is much simpler in the long run. This is because most of the time when you admit yourself to the hospital, you are there voluntarily which means there are many extra steps you don't have to go through to be discharged (more on that later). The process of being admitted usually follows a set of steps.
1) You research and determine which hospital you would want or need to be admitted to. This can be influenced by a number of factors. The primary one is if they take your health insurance or not. Other factors include location, availability on beds, doctors and programs available, as well as reviews. As my experience went on through my series of hospitalizations, I began to take all of these factors into consideration when looking into a hospital.
2) You call the hospital and ask for the admissions department. This is usually followed up with either making an in-person appointment for an evaluation or doing an evaluation over the phone. One hospital I went to did evaluations over the phone. Others required it to be done in person.
3) You go through an evaluation. This evaluation is used to determine the necessity of you needing hospitalization. This evaluation goes over various points in your mental state and takes all into consideration about whether a hospital stay is necessary. When doing a phone evaluation, there is a risk one takes and that is that if the admissions staff determines you need help right away, they will call 911 and send someone out to your house which will lead to you being taken to a local ER and evaluated there (more on this shortly).
4) Hospital sends your case to the doctors and the doctors will decide whether to accept you as a patient or not. This is generally the most nerve-racking part of the whole process because if you don't get accepted, the process starts all over again. Usually, the admissions staff will present your case to the psychiatrists there and one will accept you. This is usually the doctor you get assigned to for your stay there.
5) You are from there admitted into the hospital and fill out a bunch of paperwork that goes over rules and regulations, insurance stuff, contact information and emergency contact information.

The other way to being admitted to a psychiatric hospital is through the ER or medical hospital. This usually takes place when people are hospitalized after a suicide attempt or when they go to the ER reporting suicidal thoughts. This can also take place if someone calls 911 because they are worried about your safety. This includes crisis line staff, admissions staff at hospitals and friends and family. Anyone can really call 911 on you and tell them that you are suicidal and usually both police officers and EMTs will show up at your place. From there, you are asked a series of questions about your mental state and if you agree to go, you will be transported by ambulance to the closest hospital that is designated to handle psychiatric patients. (Note: This may not be the closest ER. Many places have certain hospitals that are designated to handle psychiatric patients in the ER and when you are determined to be a psych patient, that is where you are brought.) Once you arrive at the hospital a number of things take place.
1) You are evaluated in the ER by a social worker or psychiatrist. Many hospitals don't keep psychiatrists on site anymore so it is usually done by a social worker or through a video chat with a psychiatrist. This evaluation will determine if you are involuntarily committed or not. Many times there are other things added prior to being evaluated depending on the hospital. Blood work is usually taken and a medical clearance is done, especially if they anticipate putting you on commitment papers. Certain hospitals require you to change into paper scrubs to further show that you are committed and then turn in all your belongings. Security will lock up your valuables and the rest will be kept in the ER behind the nurses station. This means that you are not allowed to have your cellphone or any other personal items with you during this process.
2) If you are put on involuntary commitment, a few things take place to make this happen: the report by the person who evaluated you is used to fill out a bunch of forms explaining why you need to be committed, then you are informed that you have been committed and are no longer considered voluntary, then social workers in the hospital begin looking for a hospital to accept you as a patient.
3) When you are accepted by a hospital, you will be cleared medically and then transported by hospital cop to the designated hospital. Before leaving, your belongings will all be turned over to the hospital cop who is assigned to transport you. Sometimes you have to stop at the hospitals belongings desk to sign for some of your belongings. Depending on the cop, you may be restrained during your transport to the hospital. This can be through padded cuffs on hands and feet. It all depends on the cop, the hospital and your demeanor whether or not you are restrained during the transport. The drive itself is very uncomfortable if you are tall or a bigger person because the cars are equipped just like cop cars with protection between you and the driver. There is also a camera that the cop can use to monitor you throughout the drive. Because of all the protective equipment, there is not much leg room. Occasionally, depending on the time of day and the drive and the cop as well, you may be granted a pillow and blanket for the drive. This all depends on the cop and the situation. Other than the pillow and blanket, you are not allowed to have any personal belongings in the car with you. Sometimes the cop is nice enough to let you choose the radio station, sometimes not so much. This is one thing that made my drive even more difficult because I'm triggered by certain music so if the cop decided to listen to classic rock it was a very difficult drive. The drive is usually very quiet and you spend most of it in your thoughts, which considering the situation is usually a horrible situation to be in. I have cried during my transports, I have prayed, I have tried to do everything to keep my mind occupied during the drive, even if that means watching the GPS and road signs. It is a miserable trip. Once you arrive at the hospital, the cop escorts you to either the general entrance of the hospital or in some cases to the designated unit. From there, they hand your paperwork to staff at the hospital and you go into the admitting process. 4) The admitting process is usually the same whether you are voluntary or involuntary. You still go through a series of questions as to why you are there and have to fill out paperwork regarding general information (sometimes it is bypassed though depending on commitment paperwork) This concludes the process to getting admitted to the hospital. Next post will be what the intake process is like and examples of rules and regulations in hospitals. Please note: This is all based on my personal experiencess. However, I have been in 8 different psychiatric hospitals and multiple ER's belonging to different hospital companies.

Grief

Grief is something that every single human being will go through at some point in their lives. Grief can be over a loss of a friend or family member, over a change in a life situation such as new house, new job, new car. There are many situations that can cause grief. Typically, once the grieving process begins there are 5 stages: Denial & Isolation, Anger, Bargaining, Depression and Acceptance. Originally, it was thought that we go through these stages in this order. However, every person's grief is different. We spend different amounts of time in different stages and we can go through the stages in any order.
But what happens when the person grieving already has a mental illness? How does that change things? Personally, I have thought so much about this recently as I have been starting the grieving process myself because of the death of my mom, and now a friend as well.
I believe having a mental illness changes grieving in the following ways:
1) People with mental illness can have more severe reactions when grieving. I say this, not to minimize other's grieving processes and experiences but rather to point out that those with mental illness already have an extra emotional struggle on their plate and thus aren't always equipped to handle emotional struggles that come their way. Many suicides attempts are fatal by people who have a mental illness. When having a mental illness, it means we have physical characteristics in our brain that make us react differently to the world around us. Those with depression are not simply sad or even really or super sad. It is something on a whole different level. Those with anxiety are not nervous or even really nervous. Those with addiction or alcoholism don't simply drink or use drugs, it's something that's an addiction to the point where they almost lose control to it. Those with borderline personality disorder are not just emotional and sensitive, they physically feel things to a completely different extent. This is what makes grief so difficult for those with mental illness. We are already prone to having over the top reactions to situations in life or even nothing at all. Add stress into the mix and things get kinda shaky. That's where I bring in the point that grief to those of us with mental illness is different. Personally, since the death of my mom, I have been more angry than I have been in a really long time. And not just angry but irritable too, like the littlest things send me over the edge. I've been dissociating more, isolating more, and suffering more severe symptoms of depression than I have in a long time. That is part of my mental illness but it is also in response to the grief. My grieving looks different because my brain acts different. Another part of the severe reactions is that there are many people who commit suicide because of grief. My grandmother did and that makes me even more at risk for doing something similar.
Relating this on a more personal level and to give a clear example, my mother passed away 2 1/2 weeks ago. Since her passing, there have been symptoms of my depression that are making their way back in. I'm not eating much, which isn't characteristic for me. I'm also going through periods of time where I don't sleep much at all during the nights and then my body gets so physically exhausted that I will sleep for 14, 15, 16 hours at a time. I'm not able to concentrate well and my motivation is out the window. I've either been extremely tearful or not able to shed a single tear. One extreme or the other. I lay in bed for hours staring at my iPad hoping that the time will pass. I'm fighting the urge to isolate more than anything right now but even still, I'm isolating when I should be reaching out. When it comes to anxiety, I'm having 2 or 3 anxiety attacks in a day, some so severe they make me feel like I'm going to throw up when they rarely reach this intensity. When it comes to my Borderline Personality Disorder, I'm showing more severe signs of anger and irritability (and I am not one to show that I'm angry or irritable, so it's an incredible struggle to fight). I'm engaging in destructive habits again. My obsessive like thoughts of suicide and self-harm are much more present than they were before. I'm severely dissociating, worse than I ever have in my life. I'm paranoid at work and home. All of this is in response to the passing of my mother. My personal grieving process looks like this and it only looks like this because I have a mental illness.
2) People with mental illness need different support when grieving. Many people with mental illness have a therapist and psychiatrist already because of their mental illness. The help they need from them continues as a person grieves. It may even become more necessary due to the more severe reactions described above. Yes, people who don't have a mental illness will often seek out counseling and therapy when dealing with grief, but it is usually not right away. It is only after a period of time of struggling with grief that people will seek out counseling to help with their grief. People with mental illness have that support often the moment the grieving starts, if they are in treatment already. Additionally, people with mental illness need friends and family just like those without mental illness. But the support looks different in many cases. Many times, it's a friend to just sit with a person so they are not alone and to help keep themselves safe, often from their own minds. Other times, it's a person to talk to about the grief. Other times, it's to talk to someone about something that has nothing to do with the grief. Personally, since the passing of my mom, I have been the one to choose who I open up to and who I tell how I'm doing. I shut out people who demand to know how I'm doing and even times people who just ask in general "how are you", I can't answer them. Because of my mental illness, I have been extremely selective in who I talk to about my mom and when I talk to them about it. It's all been my choice. And that's hard for people who want to know how I'm really doing all the time and I can't give them an answer because I can't spit out my thoughts and feelings at the moment. That's why there is the support of a therapist and a psychiatrist as well as friends and family. The support need is different.
3) People with mental illness have different physical needs when grieving. What's the most common thing people do for a family that's just lost someone? Bring them food. While that is great for many people who are grieving, for those with a mental illness that can be a difficult thing and even a triggering thing. Because of the severe reactions, there are times when they don't want to eat because the depression is so bad and other times where they want to eat everything in sight. Other times, when they only want to eat specific items. This also applies to those with eating disorders. Food can be a big trigger for those with eating disorders as they struggle on whether they should eat the food that was brought for them. The food can sometimes be eaten, sometimes not be eaten and sometimes go to waste which can lead to major guilt. People with mental illness don't always need meals brought to them. It can sometimes hurt more than help.

So what can you do to help those who have a mental illness who are grieving a loss?
1) Support them through their severe reactions. Some reactions don't make sense to them or to you and that's all part of grieving with a mental illness. Be aware that there may be severe reactions from the person and that it's not your fault that they are acting this way. Be aware that sometimes extreme anger directed towards you may not be meant for you. When a person is open for talking, ask them about their reactions and their emotions and anything you can do to help them through their severe emotions.
2) Support them as a friend/family. This includes so many things. This means being the person they need when they need it but maintaining a healthy relationship as well. Make sure you are well supported and kept healthy through the entire process. Recognize when you can't be what the person needs and help that person find someone who can. This means that you as a supporter can play many roles, You can be a shoulder to cry, an ear to talk off, or just someone to sit with. You can be someone to be normal with too. Ask the person what they need and if they don't know, that's okay too. Offer support but don't push. The biggest thing is you recognize them going downhill and beyond what you can do to help them, HELP THEM SEEK PROFESSIONAL HELP! This could mean going with them to the appointments and describing what you are witnessing. But make sure that if you can't do it, they get the support they need from someone who can. Set healthy boundaries with the person while making it clear that you are not leaving them or abandoning them in this difficult time. Remind them of their importance and your care for them.
3) Ask what they need. If they need food, bring food. If they need supplies and toiletries, a gift card is always an option. If they need a ride somewhere or help figuring out something, anything you can do to help is encouraging. Personal notes and cards are always encouraging as well, especially when it's past the usual 2 week mark of the loss and the cards have stopped coming.
4) The most important thing to do to help anyone who is grieving is just to be there and be there through the long haul. Through the dark and the light, through good days and bad days. That's what grieving people need, especially those with a mental illness.

Personally, I still need support through each day and still need people to understand the reactions I have. This is something that is just beginning and may go on for a long time as grief can be a long process. That's why it's so important to recognize that when a person is grieving, especially a person with a mental illness, that the grieving process looks different for everyone.

The War with Depression

Depression is like a war. Each day is a battle. I go through times where I easily win my battle with depression every day. I can manage work, school, and daily life stressors with ease. I can handle bumps in the road. I manage my sleep and my appetite stays fairly consistent. My emotions aren't out of control and I don't participate in self-harm. I handle any triggers using coping skills I know and choose not to engage in any risky behavior. I also go through times where it feels like depression wins the battles. Where my sleep and appetite aren't consistent, my emotions are all over the place, my mind is the battlefield, and every life stressor feels like a nuclear bomb went off inside my chest. I've gotten really good through the years at making it difficult to tell which time is which just by looking at me. If you talk to me or read my facebook posts, you may get a better feel for where I am on my relationship with my depression.

That leads me to where I am now. I feel like in my war with depression, I'm losing more battles than I'm winning. I'm still able to make myself get out of bed and go to work. I'm still able to get myself to get my schoolwork done. Those battles I win. However, most other battles, I feel like I'm losing. My suicidal thoughts are getting stronger and more intense. My emotions are all over the place. I'm super sensitive to every little thing and paranoia has taken over. I feel extremely alone and like I don't have anyone to talk to. I feel like if I did reach out, I would be burdening people I've already worn out and will only continue to burn bridges. I'm mentally beating myself up and degrading myself and this only contributes to the suicidal thoughts.

I recognize that I'm on a sinking ship. Most people on a sinking ship would seek out life vests. Most people in my situation would have multiple life vests. These include: a solid support system, hospital options (whether inpatient or intensive outpatient), outpatient providers, and medications. When it comes to these life vests, few of them exist for me. I don't have a solid support system to depend on because too many bridges have been burned. I don't have medication options. That's part of what caused this issue in the first place and any anti-depressant medication takes 6-8 weeks to work and I am not sure if I will be able to continue to win enough battles to maintain this war for that long. Hospitalizations are out because hospitals flat out won't take me. They claim they can't help me but it's more of they won't help me and they don't want the liability. This leaves outpatient providers. When it comes to outpatient providers, I have an outstanding therapist who is fantastic but she is the only one I have. If I am honest with her about where I am,  I know what she will suggest. She will want me to do crisis group which is three hours of therapy groups and seeing a psychiatrist once a week. Sounds good right? Only this is the WORST possible time to do that because work needs me more than ever right now and tutoring is about to pick up because school is starting. I also can't afford to lose work hours because I need the money more than ever with my financial issues going on. I feel like I'm in a lose-lose situation. If I do the crisis group, I could lose my job. But there aren't any other options left.

I'm a wounded soldier in a war with too many battles left to fight and not enough ammunition or armor.

Is that safe?

This week I saw a nurse practitioner for my medications. I had never seen this lady before but had heard good things about her from my therapist and a psychiatrist that I had seen before he retired. I had multiple appointments scheduled before but every time I was supposed to see her, the appointment had gotten cancelled for one reason or another. So I was highly anticipating my appointment with her.
Recently, I've been having difficulties taking my medication because my gag reflex is so strong that I either feel like I'm going to throw up when I take my medications or I actually do throw up. It's not been fun. So I've been off of my medications for over a month now. I can tell the difference between me being on medications and me not being on medications and it's not a positive one. My therapist was aware of this and had sent her an email explaining the situation so she would know what was going on. So I was really looking forward to this appointment to address the issue with her.
I was really disappointed in the appointment. I left the appointment so frustrated I was almost in tears. Here is a list of reasons why I was frustrated:
1) I arrived there and she made multiple comments about my weight. I'm not bothered by my weight but if someone makes comments about it, it really bothers me. She commented that if I was having trouble with my appetite I should be losing more weight than I had, like my weight was proof that I was lying about my symptoms. She asked me why I thought I wasn't losing more weight and then proceeded to question me about my eating and drinking habits. I explained that while I do drink a lot of soda, I generally eat fairly healthy. I eat lots of fruits and vegetables as well as protein like chicken. So I didn't know why my weight was where it was. She lectured me about my eating habits which just irritated me.
2) When we began discussing me being off of my medications, she commented that I was on a lot of medications and that I seemed to be doing fine without them. She then asked if I should just stay off of medication. She made a judgment based on my appearance and wanted to keep me off medications based on that judgment. She didn't take into consideration the fact that I was on a lot of medications for a reason. She also didn't evaluate me by asking about my symptoms right away, she just assumed by the way I looked that I was okay.
3) While discussing whether I should go back on medications or not, she asked me what I was doing to help myself. I told her I was seeing my therapist twice a week and doing good work there. She asked me about attending groups and I said I couldn't because of my work schedule. She then said that I should focus on my mental health and work is just something extra. But it's not something extra for me. Work is part of my identity and not just a part but a key part. She acted like I should just drop everything to attend as many things as possible and that work wasn't important. However, if I had gone in there not working, I probably would have gotten a lecture about that. Just frustrating.
4) Probably the MOST frustrating part of the entire appointment was when she asked me what I do for work. I responded saying that I work in a daycare. Her response was "is that safe?" I was dumbfounded and shocked to say the least. I understand the need to ask if I'm at risk for harming someone else, but there are a thousand other ways that question can be asked. Additionally, the question just perpetuates stigma. Almost every job has some aspect of working with other people in it so if she was really concerned about me being homicidal, she should have asked that. However, instead, she revealed that she has an idea about people with mental illness that they shouldn't be caring for children. What about the people with mental illness who have children of their own? Why can't someone with mental illness care for children if they are safe with them? Just because someone has a mental illness doesn't mean they can't work a job and do what they love in their job. People with mental illness are no different than someone who has a physical illness. If that person can physically do their job, there should be no questions on whether or not they should be working that job. As the appointment continued she also made multiple jabs to me about my job. Anytime something came up that she disagreed with, she would make the comment "is that safe for the children?". This just bothered me even more. My job is a HUGE part of my identity and something that if anything, helps my mental health and gives me reasons to keep going. It gives me a reason to get up in the morning and something to look forward to. An attack on my job is very much a personal attack because of how important it is to me. Not only that, but my bosses are aware of the full extent of my mental illness and if they didn't feel comfortable leaving me alone with children, I wouldn't be left alone with them. Additionally, I'm freaking good at my job. Not trying to brag or anything when I say that but when you get noticed by a corporate worker on how well you do with curriculum with the kids, that's kind of a big deal. Plus, all the parents in my class love me and so do the kids. So the comment about whether it was safe or not to be around children was hurtful and frustrating. What a way to perpetuate stigma.
5) Another thing that really frustrated me was the expectation that I could choose whether or not to have symptoms. She made comments about my sleep, my appetite, and my suicidal thoughts. I had to explain the fact that I was chronically suicidal and she proceeded to ask me why. Like I could control the thoughts. I can't. I can choose whether to dwell on them or act on them or not, but I can't control the thoughts themselves. That's just something that is part of my reality and something that has to be monitored. And when it came to my sleep and my appetite, I can't control whether or not I can't sleep or sleep too much. I can't control whether or not I have an appetite. I wish I could, but I can't. That's all part of depression. If she wants that to change, maybe she should be trying to work with me on medications to help that.
6) The last thing that frustrated me was what she did with my medications. She wanted me to restart my medications on the same dosages I was on before, which isn't a good idea because it makes for an increased risk of side effects. I need to be built up to the dose I was on. And she wants me to choose what medication I start first. She doesn't want me to start all the medications at once, but gave no guidance on which ones I should start first. So frustrating and not helpful.
Overall, the appointment was a huge disappointment and so frustrating. Even when talking with my therapist, she was frustrated too. She knew I didn't like the person I saw and knew I wanted to see someone else. However, she said she would talk to the nurse practitioner first so that she didn't get in trouble. She is supposed to look into that and hopefully get back to me.

I think what is most troubling about the whole thing is that the nurse practitioner works in the mental health field yet still stigmatizes patients. How can someone with so much experience in the field still carry so many uneducated views about mental illness? This is one of the big problems with the mental health system. The people who are supposed to be the ones helping the patients and decreasing stigma, further it. So much change needs to take place to start eliminating stigma. It starts with one person at a time being willing to step up and say I will not accept the stigma anymore.

To my friends

I sat among a group of friends on Thursday night. We laughed and cried and really had a good time. But I couldn't help but feel like I was on the outs of the group. I felt my friends closeness around me yet didn't feel that to anyone around me. And I started to wonder why. I used to feel close with these people. I used to feel like I could be open and honest about what was going on in my life. So what changed? 

And that's when someone told me. People don't deal with loss well and the risk that they could lose me is scary. So they hold me at arms length to protect themselves. 

This is my response:

Dear friends,

I know this is scary for you. I know that being close to me is a risk. I have severe mental illness. I have a disability that puts me at risk of hurting myself. I won't deny that. But this is the reality of my illness. It's not something I have control over though I wish I did. My mind torments me day in and day out. 

What I need you to understand is that I need you. I need your support and your love. I don't have family support so friends are all I have. I know it's a risk for you but the closer you are to me, the less likely I am to do something serious to hurt myself. The closer I feel to people, the more likely I am to reach out and ask for help. The reason behind this is that when I don't feel close to people around me, I feel like a burden to people. This means I don't reach out when I need help and instead try to handle it on my own. That's when the risk of me hurting myself increases. 

Friends, I need you. The more I feel like I have support, the more stable I can be. The more stable I am, the more support I can offer in return. When I have you around, I know I'm loved and cared for and it would make a difference if I decided to check out and leave the planet. I don't feel like a burden as much. I still struggle, yes. I still have bad days, some really bad days. But when I have those bad days I know I can make it. Friends, when I don't have you around, when I don't feel close to anyone, I feel like I'm fighting this battle alone. And it takes all my energy. All my strength. All my mental capacity. I can only focus on trying to keep myself from drowning. It makes me seem like a selfish person when I don't intend to be one. When I can lean on others, I can let others lean on me. 

Friends, I can see how this is scary for you. I can see how this is a risk. I can see how this would be difficult for you. I know I'm not an easy person to be around sometimes or a lot of the time. It will take time for me to stabilize out with your support. But with your help, I can grow and in turn help you out. I need you. I love you. Please give me a chance.

Sincerely, 

Kimberly