This is a personal post about mental illness and experience within mental health services that has some sensitive themes. I am tired of not speaking.
‘Could I speak to my psychiatrist, please? I need a referral to St. Patrick’s Hospital.’ I whispered into the phone. The receptionist at my local mental health services was on the other end.
I was curled in a ball on the stairs. I hadn’t stopped crying for days. Even speaking was difficult because the words weren’t conveying the physical pain I was in at the time. Thinking about it now makes me well up. The emptiness. The anguish. The desire to make it all stop.
‘She’s not here, she’s on holiday till next week.’
My stomach dropped.
‘I’m suicidal, I need a referral.’ I cried at this point. I couldn’t help it. I couldn’t help a thing. I was not in control of my emotions. Depression owned me. Rapid cycling dictated my mental state on a daily basis. BPD was in charge of me, and not the other way around. I was listing in an angry sea of feelings and sadness that I was utterly lost in.
‘This has never happened before.’ The receptionist said, meaning that no one had called in crisis requesting a referral
(something I find very hard to believe) and popped me on hold for a few moments. She came back and offered to let me speak to a mental health nurse. I took the offer. There was no one else.
I told him I was suicidal. Really, intensely suicidal. I was full of pain. I was full of anger and sadness and I didn’t have enough skin and muscle and bone to contain every single ounce of everything I was feeling. I was one person drowning in a sea of feelings and emotions I had never been taught to control, to accept, to contain.
‘Your psychiatrist is away till next week. Can you wait a week?’
This. This is why people don’t reach out. This is why people die. This is the epitome of everything that is wrong with our mental health services. I reached out, and begged – actually, literally begged – for help. I begged to be thrown a lifeline. The lifeline fell short of being able to reach me. Tossed ineffectually into the water, just a few feet too far away from where I was treading in the inky, dark liquid.
He advised me, if I was ‘really that bad’, to ‘go to A&E’, or wait until she got back.
Go to A&E, where I would wait 6 hours, drowning in my demons, to be seen to. To then be told to go home.
I was told to wait a week before killing myself.
I was taking a desperate last-ditch attempt to get myself out of the state of pain I was in. To stop the anxiety. To make it all stop, before I tried to.
I battled for two weeks to get my referral. I know in my heart others would’ve given up. I believe that, had it gone on longer, there would have been nothing stopping me from giving up.
Of course, a referral doesn’t do anything. Getting in to hospital is one thing. Getting the help out of it is another entirely. I was lucky. I will always, always say how god damn lucky I was to have had a couple of months of insurance left. Just enough to see me able to function. I was lucky that DBT worked for me. I was lucky that I had people on my multi-disciplinary team that listened to me and worked with me. I was lucky, so very lucky.
My insurance is up. The facilitators in my DBT group advised me to put my name down for external DBT services. I could be waiting a year, they said, and by the time I was accepted for assessment, I probably wouldn’t be a suitable candidate for the services anymore. That’s what people who haven’t had a chance to go to private hospital are facing. Hell, I didn’t complete the DBT course. My insurance ran out before I could. I have basic survival skills and some interpersonal effectiveness ones, but we didn’t cover everything. I have just about enough to get me through most days. It does work. It did help. There is always more I can do. I’m better now than I was, but I still have bad days. God, do I have bad days. They aren’t on the scale that they were on the weeks and months surrounding that phone call, but week by week I am improving. I am able to cope with more and more and more. Sometimes I forget my skills and the anxiety comes creeping back in in varying intensities, or creeps in despite them.
I have borderline personality disorder. I am not crazy. Depression and anxiety are major, major symptoms of my diagnoses (as rapid cycling (bipolar-II) also has both as a feature). The term ‘personality disorder’ will always make people shrink back and think that it’s a permanent state of being, but it’s not. It comes and goes. (
and I think personality disorder is probably the worst category to put it in, but then again, this is the same categorisation that had being gay down as a mental illness up until a few years ago) It all boils down to ineffective coping mechanisms. Some people learn them as they grow up. Others are more sensitive and need to be taught how to process things that are inherently human. I have bad days, just like everyone else with depression. I have bad days, just like everyone else with anxiety. The only difference is that I cannot take medication. It makes me worse, not better. A lot of people experience that. Meds help so many people and hinder so many others. Diagnosis is a key element in that. I can’t take medication for depression because it is a symptom of my illness, not illness itself.
Even typing this, I feel ingrained stigma seeping through my veins, making my hands shake as the words appear on the screen. Words that are pulsing around my body, dying to be out. I don’t want to live in silence anymore. Some things do not go away with help, but they can get better in varying degrees. My experience does not make me more brave or more worthy of help than anyone else. I got lucky. I got so lucky, in fact, that after a year of waiting to get therapy from my local mental health services I have finally got an appointment and I feel actual, genuine guilt because there are people out there who need it more than me. The thing is, BPD sucks. It really, genuinely sucks. But it doesn’t make me who I am. It is a part of me that I have to be mindful of on a daily basis. I have to be mindful of my limitations and I have to be careful not to get overwhelmed, but it does not define me as a person. It does not stop me from holding down a job (although I really do have days where I can barely stand up from the intensity of anxiety) and it does not stop me from spending time with the people I love. It does not stop me from speaking or writing or creating. I am not creative because of my diagnoses. I am creative in spite of them. I am a person worthy of help, as is every single other person living with and struggling with BPD, and other illnesses. I am not living in stigma anymore. There is so much complete and utter unadulterated SHITE on the internet about BPD and what it is and what the people are like who have it, but guess what? It’s a spectrum, and the people on the severe end of the spectrum are really, really ill and could probably do without your unwarranted criticism, thank you very much. The people on the middle and mild ends of the scale are probably coping really well for a person with BPD, but not so good for someone who is neurotypical. I wrote about it many months ago. Not just for the people who were being hurt by the SHITE on the internet, but for me, too.
I am a different person than I was all those months ago, crying into the phone and begging for help. It does not mean that I don’t still struggle. I have well days and bad days. This has not been helped by an atrocious mental healthcare system which serves those lucky enough to be able to pay for it
(I don’t for a second forget to acknowledge my privilege in this instance) first and leaves the rest to suffer in silence. My experience with local mental health services has been long and drawn out and had I not gone to hospital, it would have been totally inadequate simply because I cannot take medication so they had nowhere to send me. I am only now getting therapy because they finally got people to fill positions which had lain vacant for 6 months. I am surviving because I need to and want to. I am a fighter. I will always fight. But where my determination worked for me may prove detrimental for someone else fighting. If the help is not willingly there, how will someone determined to take their own life ever recover in any sense of the word? How will they take back their life from something that is so easily treated in the right hands – and that goes for any and all mental illnesses – if they can’t get the treatment without a protracted battle ensuing first? How does someone vulnerable have to prove their worth – worth they cannot see! – in a country that forces women to carry babies to protect the life of a child when that child can grow up in a country that does not care if a person is determined to die by suicide? How does that make sense to anyone?
Really, I should shut up. I should stay quiet. Go about my life. Live with the stigma and in silence because of the misconceptions surrounding BPD, and any form of bipolar, and anything and everything that isn’t straight up anxiety and depression. But do you know what? Not anymore. I am unashamed. I will keep talking, and keep advocating, and keep writing and speaking and raising the sort of awareness we need – awareness about other illnesses that aren’t acknowledged, and awareness about illnesses that do not go away after a walk and a bowl of leafy salad as is often suggested by those damn ‘little things’ campaigns. Awareness about the fact that the system we have is so inadequate that it asks a person to hold off on killing themselves for another week, when that person has pretty much decided that this is happening, and it’s happening now unless someone can intervene. Families can only do so much. Families should only have to do so much, before the professionals can step in where needed. I am so sick of seeing people say they didn’t get the help they needed, or that they were referred back to their GP to have more medication shoved at them that isn’t working but the GP doesn’t know what else to do so just suggests that they keep trying. I’m sick of trying, and of knowing that fighting is necessary. If I rocked up to a hospital completely and utterly drunk with a gaping wound in my head, I’d be seen to almost immediately. Drunkenness is self inflicted, and the wound was a by-product. Mental illness is not self inflicted. Death should not be a by-product. Yet, one gets immediate treatment. The other will be forced to wait. One is seen as an emergency. The other is not.
That isn’t fair. They say life isn’t fair, but this country really does a lot by way of making sure that fairness is dictated by your social status and income. ‘The more the merrier’ springs to mind, because the more money you have, the better off you’ll probably end up being. Something’s gotta give.