Paroxetine = One Murderous Girl

On reviewing this post I find there’s a fair amount of not so passive aggression – sorry. I blame drugs and pent up frustration. Also, the writing sucks, but I’m not trying so I don’t really care.

I am reduced to drinking instant Nescafe decaf coffee as I type. I’m not in a rooibos mood and as sleep has been challenging lately I don’t want to drink real tea or use one of my coffee bags. I’ve been here 33 days and I’m on my third box of 28 pack coffee bags.

I was supposed to be discharged today but as my psychiatrist came to see me last night and caught me in a murderous rage he decided against it. In store is a reduction in my new antidepressant; the agitation, rage, extra suicidal impulses and plotting to destroy the entire world coincided with the dose increase. I think I scared him last night. I told him off, swore a lot and when asked what I’d be feeling as I blew up myself and took the whole world with me I replied that I’d be laughing. Looking back on this I can see why I’m still here.

My three friends in here are all gone. Only one said goodbye, guess I won’t be seeing them again. I struggle so much to make friends and I scare the ones I manage to make away with the whole being a super introvert and having BPD thingy. Also there’s just not enough happy stuff to share, people don’t want to be hearing about all the crap, they want kittens and teddy bears. I have a stat counter on this thing – the happy titled posts get a lot more hits, my happy, shallow facebook comments get more comments. I could say “I just spent the last 5 hours crying, does anyone want to come over for a cup of tea” and no one would reply. But “My cat just chewed right through my knitting yarn” 5 or so comments and a dozen likes. I’m not popular okay – 5 is a lot for me!

One disgusting tasting antibiotic left but the cough persists. I’ve had my annual dose of radiation and then some this year, I hope this doesn’t result in a chest x-ray.

The final ever episode of Dexter has aired and I haven’t been able to watch it because there’s no wifi in here and I’ve almost reached my monthly data limit on my phone. I’m waiting for mum to bring it in but not sure when that will be. Really this season has sucked, but I want to know how it all ends and I refuse to read about it

Questioning what to do with my life – very slowly finish the masters and then do who knows what with it, give up on study and just write something and see where it goes, die? Even if it’s small some part of me wants to live, or I wouldn’t have sought help before this admission or told my nurse yesterday about the perfect hanging point I found in the hospital – it was promptly removed.

I wrote this on Tuesday night:

Tue 24^th September

I found a hanging point in the hospital; tomorrow I will show it to my nurse to hopefully save some other depressed, hopeless soul from using it. I made the noose – they’re bloody hard to get right! I wrote the letter, including passwords to everything. I tested the hanging point and then feared that my cord may not hold my weight and the involuntary thrashing would attract attention before death. Surviving a hanging may result in permanent brain damage – no thanks!

Nine weeks until the family trip to the UK for a month. I am terrified.

Bullets

Little update:

• Possibly going home at weekend. 
• Have chest infection - not tuberculosis as my hyperchondriac side suggested when the blood coughing started.
• Met some lovely people in here. 
• Psychiatrist looking into accommodation options for me.
• New antidepressant seems to be working. 
• Mogadon (sleeping pill) was probably invented by God himself. 
• Been binge eating and learnt tonight I've gained 8kg.
• Uni deferred for semester.
• I know I've had many hospital admissions over the last three years so no one sees them as a big deal now, but I'm feeling pretty uncared for. I've been told off for feeling like this because you all have your own problems and work etc too, I'm just saying it's how I feel. 
• Weirdest dreams of my life in the last fortnight. 
• Knitting lots
• Candy crush is evil
• Still want to die but I don't think I could do that to my mum and I hate her for that. 
• Mogadon kicking in, time to go. 

Hospital Friend Art

Tonight three girls on my unit and I took a canvas each, painted / drew / wrote – etc on it and passed it around, so we each contributed some to each one. They can be connected in any combination by a series of coloured circles in each corner. Here are many pictures. I get to keep the yellow one. Also, I would like to claim credit for the cow with the bee body!

K's Shopping Terror

Let's all go shopping!

Dream in a Dream in Limbo in Dream

Sometimes I dream the future, not often and never anything of consequence. But it can get a bit spooky. Today in a drug induced sleep I had a dream within a dream within a dream in which I was in limbo for killing myself in a dream and to escape I had to find my body in a hospital and wake it up. I found the body and tried to wake it up, then I awoke in reality to find myself in my hospital bed absolutely terrified.
All this after being drugged because I'm pretty bent on killing myself at the moment, lesson from dream: limbo is frightening.
That's only a fraction of the dream. I wrote the whole thing for my own memory and it was epic, so I won't be posting that.

Admission # 4543986

Here I am in hospital again; I arrived on Saturday following three days of panicked medical practitioners and a visit from the CAT team (really it should just be CAT, because the T stands for team, but it sounds incomplete without adding team on the end). I am very fortunate to be here, after the incident in my last private admission I should be black-listed, but they agreed to take me on the condition that I have no leave - which I am fine with as I don’t trust myself out and about anyway. Precipitating my admission was an overwhelming sense of hopelessness, which is still present, a very detailed and certain to work suicide plan and severe social phobia. The suicide plan still exists, the only reason I’m not bent on carrying it out is that my mother has already lost her husband this year, and perhaps losing her daughter so soon would be unpleasant. I can’t win with the social phobia, I get extremely lonely, but the idea of being around people is terrifying. One-on-ones are fine, but only my mother has been to visit. The dining room is hard, so many people talking at once, and I can’t always get a table to myself. Unlike Vic Clinic – which I’m now banned from – this hospital is mostly private rooms, and they’re quite nice, so staying in my room is not the grim experience it is at Vic Clinic.

Medication-wise; I’m withdrawing from Zoloft, which sucks; re-introduced to Valium, which takes the edge off the terror of venturing into the dining room and therapy groups. My psychiatrist hasn’t yet decided whether to start me on a new anti-depressant or to see how I go without, since historically they tend to make me worse, but do improve my anxiety. ECT is unlikely because of the damage it has inflicted on my memory, I’m willing to have it though because I figure the damage is done, so why not ruin it some more. (Plus I really like the anesthetic).

That’s all for this update.

Seroquel = Good

Basically, things really suck at the moment.

Crowds of more than a handful of people = bad

Being awake = bad

Being alone = bad

Being with people = bad

New experiences = bad

Boredom = bad

Lester (cat) = good

Future prospects = bad

Suicide = very attractive, considered more carefully and thoroughly than in the past, date and place in mind. Pity I always forfeit at the last moment.

Borderline Personality Disorder Explained

I posted this in full rather than just the link because I want you to read it, not just see a link and move on. I've included the authorship details just so it's very clear this is not my work.

Explainer: what is borderline personality disorder?
http://theconversation.com/explainer-what-is-borderline-personality-disorder-12523

AUTHOR

1. 

   Andrew Chanen

   Director of Clinical Services, Orygen Youth Health, Associate Professor, the Centre for Youth Mental Health, The University of Melbourne at University of Melbourne

DISCLOSURE STATEMENT

Andrew Chanen receives funding from the National Health and Medical Research Council, the Australian Research Council, New South Wales Department of Health. The Orygen Youth Health Research Centre receives unrestricted philanthropic funding from the Colonial Foundation.

Borderline personality disorder is characterised by problems regulating emotions and thoughts.Image from shutterstock.com

We all possess a unique set of personality traits that make us who we are. These are the usual ways we perceive, think, feel, behave and relate to others, and they tend to be consistent across time and situations.

Personality traits can become “disordered” when they’re extreme and/or inflexible, making it difficult for the person to adjust to their environment. This causes significant distress and disruption to the lives of those with the disorder. And because it’s difficult to form and maintain relationships, it also affects the lives of those around them.

Borderline personality disorder (BPD) is a severe mental disorder characterised by problems regulating emotions and thoughts, unstable interpersonal relationships and self-image, and impulsive and self-damaging behaviour. The disorder exists along a continuum of severity, with symptoms varying from person to person. These might include:

Around 3% of the population – and one fifth of psychiatric patients – have BPD. Image from shutterstock.com

• emotional volatility
• excessive anger
• “black and white thinking” about relationships (being either all good or all bad)
• a distorted, unstable or unformed sense of self
• intense fears of abandonment
• chronic feelings of emptiness
• recurrent, deliberate self-harm (such as cutting)
• impulsive behaviours with a high likelihood they will cause damage, such as impulsive alcohol use, repeated unsafe sex, binge eating and so on
• feelings of unreality and suspicion when under stress.

BPD was officially recognised by the psychiatric community in 1980 and is currently diagnosed when a patient has at least five of the nine criteria listed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5). While experts generally agree that “borderline personality disorder” is a misnomer, based on the now disbelieved theory that BPD lies on the “border” between “neurosis” and “psychosis”, they have been unable to reach a consensus on a more accurate term.

The disorder affects 1% to 3% of youth and adults and one-fifth of psychiatric patients, usually beginning in adolescence or early adulthood. This, of course, increases the potential for further developmental disruption into adulthood.

People with BPD also have high rates of psychiatric disorders, such as depression, anxiety, and eating disorders and alcohol and other drug use. Sadly, up to 10% of adults with the disorder commit suicide.

Causes and risk factors

Our understanding of developmental pathways leading to BPD has been improved by recent research studies, but there is still much that is unknown. However, we know that people with a personality disorder don’t choose to feel the way they do.

It’s likely that genetics and environment play a role, with genetically “sensitive” individuals at greater risk of BPD if they find themselves in an enabling environment. A number of childhood and parental demographic characteristics, bad childhood experiences, early relational difficulties, and unhelpful parenting styles are risk factors for BPD.

But these risk factors are common to many psychiatric disorders,making it hard to explain why an individual might develop BPD, rather than another disorder.

Preliminary studies also suggest the brain regions involved in the regulation of emotions and behaviour play an important role in BPD.

Treatment

The treatment of BPD has progressed significantly over the past two decades, with new Australian guidelines outlining interventions for the management of BPD in youth and adults at all levels of the health-care system.

Several structured psychological therapies have been specifically designed for BPD. The best known and most widely practised of these is Dialectical Behaviour Therapy (DBT). This combines individual and group therapy and is directed at teaching skills to regulate intense emotional states and to reduce self-destructive behaviours.

BPD has a reputation as being difficult to treat. Image from shutterstock.com

Some features common to all of the effective therapies include having a clear treatment framework, managing emotions during therapy, the therapist being active with the patient, and using exploratory and change-oriented interventions.

When these are conducted by trained and supervised health professionals, they are effective in improving the lives of those with BPD by reducing self-destructive behaviours and improving emotional control, interpersonal relationships and vocational functioning.

Research shows that medications should not be the main treatment for BPD. Medications can be used for co-occurring problems (such as depression) and might have a very limited role as a specialist treatment for some of the symptoms of BPD, and they can lead to long-term complications.

Treatment hurdles

Many people with BPD have experienced significant adversity in their early lives, which is likely to be both a cause and an effect of BPD – and it often continues into adult life. This requires particular sensitivity among health-care professionals.

But BPD has an undeserved reputation among clinicians of being difficult to treat. Complications arise in part because the interpersonal problems at the heart of BPD also affect relationships with professionals. Consequently, patients can encounter prejudice and discrimination within the health-care system and this often compounds their difficulties.

While BPD is a severe psychiatric disorder, it responds well to treatment. The principal challenge is to strengthen the health-care system so that it can provide timely, high-quality, consistent, respectful and collaborative care for people with BPD.

http://theconversation.com/explainer-what-is-borderline-personality-disorder-12523

Psychiatric Info

Worth a read.