This evening

I am absolutely exhausted, to the point where I don't think I can keep my eyes open any more. I got very little sleep last night, and it has been a really draining day. I feel gutted. I was really determined to kill myself tonight, but my parents will still be up for another hour/hour and a half, and I don't think I can say awake that long. I feel immensely frustrated. My GP rung me earlier, after afternoon surgery. Actually she rung the landline and spoke to my mum first, but I don't know what she said to her. Then she spoke to me and said that things were really tough at the moment weren't they, and I said yes. She said how it seemed a particularly bad period, and I said it is. I talked to her for quite a while. I got quite upset several times. She said she wanted me to go and see her Friday - I said I couldn't cope and I intended to be dead by then. She said that she had spoken to L, and L had very clearly told her not to refer me to the crisis team under any circumstances. She kept saying she really wanted to see me on Friday and we could talk about things then. I said there was no point, as there was nothing she could do, and I wanted to die today, but she said she was putting it in her diary anyway and would expect to see me. She said I sounded too exhausted to act on my thoughts. I said I was absolutely shattered but that I would find the energy. And yet now I don't seem to be able to, and it is upsetting me. I can't remember what else my GP said. She was very supportive, but it was also very clear she had been told by L not to suggest admission or crisis team input, as she responded different to how she usually would, and did make a point a couple of times of saying she had spoken to L. I said how pissed off and upset I was that I felt like I was being treated like a typical Borderline, and given no support or help, when this was quite clearly a depressive episode, and that if I didn't have a BPD diagnosis there was no way on earth that I would just be left to get on with things like this with no support, and people knowing I was planning to kill myself. She didn't disagree.

My mum then wanted to talk to me. I explained to her the same BPD/Depression frustrations, and how I don't understand why when I meet every criteria without exception for one illness, and just about manage to get the 5 criteria needed for diagnosis for the other, that is seen as my primary diagnosis and I am treated based on that. She asked to see the diagnostic criteria and printed it off and said she would call L tomorrow. I also told her how much L had changed - that she used to be really supportive and caring and how she is just totally unhelpful and I think she hates me, and I think she has been taken over or replaced or something, because it is genuinely like she is a different person - based on the way she speaks to me now compared with six months ago I wouldn't recognise her as the same person. I am worried about my mum talked to L. L can clearly force her way of thinking onto others, in the way that she has with my GP (although I believe it was somehow forced onto L in the first place, but I am not sure how) and so she will make my mum think she is right about everything. All of this was probably about a ten minute conversation and then she seemed to get bored of the wanting to talk thing and went off downstairs, and then later when I said I thought she wanted to talk, she first of all said that I wouldn't ever talk to her, then remembered I had and said that we had already talked and that she wanted to go downstairs and drink her wine. I can't trust anyone. Nobody is reliable. I was prepared to tell my mum everything, including my suicidal intent, but she was more interested in going and having a glass of wine. My GP has been restricted so she is as good as useless, as she can't even refer me to someone, and it doesn't matter how sympathetic she is, if she can't do anything it doesn't help. And L has changed beyond recognition.

I can't keep my eyes open. I suppose I am going to have to sleep. Maybe I will be able to wake up in the night. I don't know. I don't want to sleep. I don't want to get through tonight. I want to die. But it appears that my GP was right and I am too bloody exhausted to even do that. I feel thoroughly useless.

Horrible day

I called the out of hours number again last night. I felt awkward doing so - I didn't know what to say, and it felt wrong as I wasn't intending to kill myself then, as today was the funeral of my mum's boss who died last week, and she was obviously going to that, and I was supposed to be as well, and something about his funeral today made me feel like it would be disrespectful and unfair to try and kill myself the night before. But I got to a point where I was feeling really tense and desperate, and although I didn't plan to kill myself then, I really needed to talk to someone, so I rung them. I spoke to a different woman to the other night, but again, she was very nice. She asked what was going on, and so I told her I had been struggling a lot and that things had been bad for several weeks, but were getting even worse. She asked when I had last been seen by the CMHT, and I said that day, and she asked if plans had been put in place to support me and I said no. I said how suicidal I was feeling, and she asked if I had a plan, and I said yes, and explained about not being able to act on it that night. She asked if I had told L I had a plan and I said she hadn't asked - that she knew I was feeling suicidal but that she says it is pointless talking about suicide and there is no mileage in it. The out of hours woman sounded a bit baffled by the whole thing to be honest. She asked if I had been honest and actually told her how bad I was feeling, and not just said I was a bit low or something, and I told her I had definitely been honest, and there was nothing I had told her that I haven't told other professionals over the last few weeks. She said they couldn't just leave me like this and that I clearly needed help, and it was urgent, and that I had to try again today. She said to speak to my GP and ask for a crisis team referral at the very least, and also to make sure L knows just how bad I feel. She was very supportive, but seemed kind of bemused by the fact that I was getting no support other than fortnightly appointments.

Following that I sent L an email, saying I had spoken to out of hours, and saying I had been advised to contact GP and ask for a crisis team referral etc, and went on to tell her how strong the thoughts were etc, and the reasons why I hadn't acted on them last night, and basically everything I had spoken to the out of hours woman about. I got a reply saying it wasn't appropriate to email those thoughts and she would prefer if I rung next time. She also said that the crisis team wouldn't get involved as I have a care coordinator, which I know is not true - they might not get involved because she tells them not to, but the fact that I have a care coordinator is completely irrelevant. I replied saying that I thought perhaps the crisis team could help, and certainly if I was to try and do the things she was suggesting then it could help, and that I thought they were there for when you are in crisis regardless of whether or not you had a care coordinator. I got a reply this afternoon saying that if I needed support to do things we could discuss a support worker next time I saw her (I had said months ago that I wished I still had a support worker but she didn't mention anything about it being a possibility then) and that the crisis team do sometimes get involved when you have a care coordinator but only in certain situations. I replied that I couldn't cope, that I couldn't even put into words how desperate I was feeling, and that I know things could improve or that things might help in the future, but that right now I just can't cope, that this is as bad as I have ever felt, if not worse, and that I have kept going for as long as I can, but I didn't get a reply to that.

I tried calling my GP this morning. She was in morning surgery, which I knew she would be, but they said they would get her to phone me when she was finished. They did the usual of asking if I could say what it was about, and I said that I was suicidal and had been told to phone her - I don't usually tell them things like that but I am just totally desperate. Morning surgery finishes at 12:30pm, although she often runs over, but I still hadn't heard anything by 2pm so I rung back and asked if they had any idea what time she might be able to ring me, and they checked that the note to call me was on the system, which it was, and said she was out at the moment but shouldn't be long and they would ask her again when she got back. Afternoon surgery starts at 4pm, and I still hadn't heard anything, and it is now 5:15. I suppose there is still a small chance my GP will call me back after afternoon surgery, but I am not holding my breath, and I don't think there is much she can do anyway. I was just calling her because the out of hours woman made me promise to.

I don't know what I am supposed to do. I have done absolutely everything I have been told to do. I have been completely honest about how bad things are. I have asked for help. I have done what the woman from the out of hours number said and tried to contact my GP, and I have made sure L knows how bad things are. But I cannot get any support at all, and I can't cope. I have tried so, so hard, and it is just hopeless. It is so clear that they either don't give a shit whether I kill myself or not, or they don't believe me. But either way there is nothing more that I can do. I have spent the last three weeks desperately trying to keep going, and get some support, but I can't get anything more than a fortnightly appointment, and my mood has just been getting lower and lower, and I just can't cope. I really wish I knew what they expected me to do. I am completely exhausted, and feel utterly hopeless.

And yes, I am sure this is all self pitying drivel and I need to stop feeling sorry for myself. But the fact is I have been trying incredibly hard to get the support I need to keep going, and it just isn't there for me. And I can't do this alone.

Diagnonsense

I have grown increasingly frustrated regarding diagnosis the last couple of weeks. I feel quite sure that if I didn't have a BPD diagnosis, I would have received more support than I have done. I am totally convinced. What my GP said to my mum about having BPD, not depression, really clinched it for me. She had said nothing like that when she spoke to me on Wednesday and thought the crisis team should be seeing me, so either the crisis team or the CMHT manager must have told her that. And the only reason they would have told her that would be as justification for why I wasn't getting more help. The frustrating thing is, I don't even see it as relevant. I don't actually think diagnosis should ever be relevant - I think symptoms should be treated/given support for, rather than the diagnosis. But I am particularly pissed off because actually I don't even feel like BPD is relevant at the moment even in terms of treating diagnoses. I am not disputing that I meet the diagnostic criteria for BPD. However, if I look at the diagnostic criteria for Depression I literally meet every single criteria at the moment. Therefore surely that is the current problem rather than BPD, and should be treated accordingly. The diagnostic criteria for BPD relating to mood is '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).' That is not me. My mood is not reactive, and it has lasted weeks, not hours or days. The only time that applies is when I have episodes when I am particularly irritable or hyper for a few hours. It never applies to my depressed or suicidal periods, and I would not consider my mood unstable - it is consistantly very low, and has been for weeks. It makes me so angry that there is still so much prejudice surrounding BPD, which there absolutely is. I don't self harm or take small overdoses and then turn up at A&E - I have never, ever done that. I don't make threats regarding suicide - I only talk about feeling suicidal if I am feeling genuinely suicidal and unable to keep myself safe. And the times I have attempted suicide have not been impulsive - it has been at times like this when I have been feeling desperate and reach a point where I can no longer cope - they have been planned. But I feel like I am being treated as though I am the 'stereotypical' borderline who takes overdoses for attention and that giving me support would be encouraging attention seeking etc. I know I meet the BPD criteria. But I also meet the criteria for Depression, and more closely in my opinion, and that is what is making me feel like this at the moment. And I honestly feel that if Depression was my only diagnosis, I would be receiving different treatment at the moment. I am sure that would be denied by the crisis team or any other professionals, but I have seen from the experiences of friends the difference in the support given to people with a BPD diagnosis, and the support given to people with mood disorder diagnoses, even if presenting with the same symptoms, and except in a few exceptional cases, those with mood disorders virtually always seem to get given more support in crisis. I know the medications I have tried have seemed to have little effect, but I am sure that if Depression was my only diagnosis then medicaations would continue to be tried until something helped. I would not just be left, when feeling suicidal, and expected to get on with things. The crisis team would have arranged the appointment with the psychiatrist that they talked about, and they would probably have continued to visit, and although they aren't always helpful, when I am feeling like this I do find it helpful to know that I have some form of support, and knowing there will be daily visits etc does make a difference. It doesn't change how I feel, but I know from past experience that it makes it easier to take things one day at a time, which is something I am struggling with at the moment, and various other things. As I said, I am sure it would be denied, but I am convinced that had my diagnosis been different, I would have received different treatment these last few weeks, and that makes me angry.

I spoke to L earlier. I can't remember what we talked about. It was only a few hours ago, but my brain just isn't working. I remember that she was supportive though, and I didn't feel like she didn't care about me. I trust her a bit more than I did. It all feels rather irrelevant though. Nobody can change how I feel, and I still have the same level of help. Or lack of.

Just stop

It is 5:15am and I am not remotely sleepy, and am feeling very tense, despite taking 10mg Diazepam. The suicidal thoughts are really in full swing, and although I am not intending to act on them tonight, it doesn't make them any weaker or easier to cope with. I think I might have to have another Diazepam, as when I feel like this my thoughts just go into overdrive and I have absolutely no chance of sleeping.

I am feeling so alone. I know I have support online, and I am truly grateful for that, but in real life I have absolutely nothing, and it is hard. Actually it is much worse than hard. I desperately feel like I need some support, but there is nowhere to turn. My GP works Wednesdays, but there is no point contacting her, as I have grasped exactly what she thinks from my mum speaking to her last week, and she has certainly been turned against me. I could phone and speak to whoever is on duty at the CMHT, but a) I don't trust that it won't be a fuckwit on duty, as there are several of them, b) they will all be against me too, and c) they will either suggest going for a walk, having a bath, or listening to music, and none of those are remotely helpful suggestions at the moment. I always find walking very anxiety provoking - I am always paranoid that someone is following me, and it really does scare me. I find baths the opposite of relaxing. I hate just lying there with my thoughts. I don't see how that is supposed to be relaxing or helpful. And I usually love music, but as I have explained on here before, I find it really difficult to listen to at the moment unless there is a particular song I need to hear - otherwise it just sounds like irritating noise that is drilling through my head, even if it is a CD I usually love. The TV is similar - I get a headache within about 5 minutes of turning it on as it just overwhelms me. And I can't concentrate to read. So essentially, anything they might suggest I do is useless, and therefore I am fucked.

I miss L. I know that sounds weird, given that she has been turned against me, and hasn't done anything to help me lately, but I do. I guess that is why attachment issues are such a bitch. Even when you know someone isn't helping, you can't get over them. I was thinking about it, and actually I don't think things have ever been quite the same with her since that time in November when I felt very let down by her. Things did get back on track and feel ok after that, but I suppose I never had quite the same level of trust in her following that, and now I feel like she doesn't care about me at all and doesn't care what happens to me, as she just left me with an appointment for a fortnight's time when she knew how awful I was feeling. And yet I still miss her. That is wrong, and it pisses me off. I am angry with myself for wanting to talk to her. I don't want to miss her. I want to be angry with her. But every time I am feeling desperate I just get this overwhelming desire to talk to her. And yet last Thursday and Friday when she was in work, and I could have rung her, I didn't because I was just too upset. I feel really confused about the whole thing. I suppose it is a bit like the situation with my mum. I still feel like she has been turned against me where my mental health is concerned, but I still love her despite that. I feel let down by her, and I feel like she either doesn't believe me, or doesn't care about me any more, in much the same way I feel about L, but she is still my mum, and I still love her. I just have to accept that I can't rely on her for support. And I suppose it would be the same with L, except our whole relationship is based on support, as that is why she is there, which makes it much more awkward, But of the CMHT she is still the only person I want to talk to. I feel lost and alone and desperate, and like the people I have relied on and trusted the most are no longer there for me. I really feel like I can't cope.

I have rehearsal again tonight. It is going to be a long one, as I have to get there an hour early to work on my solos with the musical director, and then I have the normal rehearsal, so I will be there from 6:30 until at least 10, possibly 10:30. It's all too much. I want to scream and shout and cry but I don't think that would be appreciated by my parents or my neighbours given that it is 5:30am. I just can't cope. I want out. I want to make everything stop. Just stop. Why isn't it getting any easier? Surely it should be getting easier. And it isn't. It just gets harder and harder. I don't believe that these thoughts and feelings are going to go away without me acting on them. It is too intense. And it feels like the right thing to do. I don't want to wait for them to pass. I just want to make it all stop.

Crisis team phone call - 2

The crisis team did call back as promised, at about 8pm. It was the same woman. Why is that I never get to speak to/see someone from the crisis team more than once unless I don't like them? She asked if I had spoken to my parents, and I said no. She asked if I would like her to, and I said no thank you. She asked why not, and I said that I didn't feel it would be helpful, as if I was going to act on my thoughts and knew my parents would be checking in on me in the morning, then I would use a method where time wasn't an issue. She seemed to ignore that and said she really thought I needed to speak to them, and that if they felt I was at risk and I hadn't spoken to them tomorrow then they could break confidentiality and speak to them without my consent. Just what I wanted to hear - that makes me feel so much more likely to be honest with them about my feelings. To be honest, I don't understand breaking confidentiality. I feel like if they are concerned enough about you that they feel they have to break confidentiality in order for you to stay safe, then you aren't receiving the right treatment - surely if they are that worried then they should be considering admitting you to hospital, and if they're not then I don't see what right they have to break confidentiality. That is something that really pisses me off. If I was living on my own or in supported housing they wouldn't call my parents to let them know how I was, so why should they just because I live at home? It is something I have had problems with multiple times in the past, both with the crisis team and CMHTs. I think L is probably the only care coordinator I have never had that concern with - I know she wouldn't do it, which is one of the reasons I trust her so much I suppose. So yes, that really annoyed me. She said to speak to my parents tonight and get them to come in and check on me before they go to work (which would probably be an hour after I got to sleep and would disturb me well and truly) and that then they would call me first thing in the morning (presumably to disturb me again). Bloody hope it isn't her.

She went on again about how I had got through this before and so know I can do it, and that things do get better. I said that I feel like I could never feel good enough to make it worth feeling this bad. She said we were talking in circles. It is apparently ok for her to talk in circles though, as she repeated that things aren't usually this bad, and that I have got through bad times in the past, and that I have obviously been doing a lot better in the last year or so because it has been a long time since I have been under their care. I didn't bother to tell her that is because L doesn't think it is helpful to see that and so usually just supports me herself when I am in crisis, unlike my previous care coordinator, who made me go to A&E and be assessed by them every time I was feeling suicidal. She also said that I am an intelligent girl and I understand my feelings, and that she thinks that by engaging with them that shows that I want help rather than to die. She is the type of professional I just don't get on with. I am sure she is a perfectly nice person, but I do not like being treated like a child, and I find it patronising when a professional tries to tell me that I am not really suicidal because I am asking for help or something like that, as I know how I feel, and how difficult it is to ask for help, and how much my feelings regarding help vary. I am feeling really quite frustrated and wound up.

Crisis team visit - 2

I feel like today has gone completely wrong and I am feeling really hopeless. I was told yesterday that the crisis team would call today at about 10 - 10:30am, and then probably come out to see me again. I left my phone on vibrate so that it would wake me up, and didn't bother setting an alarm because I knew that would wake me as it always does. I had said to my mum last night that I didn't feel comfortable talking to people when they were in the house so could they go to see my sister or something, and she said that was fine, but how would they know what time to go, and I said that the crisis team would be calling in the morning and so I would know what time they were coming then. That was the plan. And then I was going to try and tell them how bad things were.

I woke up to my phone ringing at 1pm, and it was a woman from the crisis team asking if I could tell them how to find me. I was thoroughly confused, as I hadn't had the morning phone call as planned. I assumed they needed vague directions, but when I asked where they were it turned out they were actually already outside the house - they just didn't know which house it was, as we like to confuse people by not having a name or number or anything on display. So that threw me into a complete tail spin, as their phone call had woken me up, as yet again it had been about 6am before I got to sleep, and obviously my parents were home as we hadn't had any warning, and I didn't even have time to do things like go to the toilet, so I was feeling really flustered and confused.

My mum came upstairs to do housework and was hoovering etc, so I didn't feel uncomfortable with her being there really, but my dad was downstairs, painting in a room virtually adjoining where I was sitting with the crisis team, he had very good hearing, and the man from the crisis team spoke very loudly and had an irritating habit of repeating everything I said. To be honest the whole thing was a complete fiasco. I felt paranoid that my dad would be listening in and so felt extremely uncomfortable, I was confused about why they had suddenly turned up without calling first like they were supposed to, and I was worried that I wouldn't be able to be honest with them because I was feeling so tense and anxious. To make matters worse they knew absolutely nothing about me, and had never even seen my notes - the reason they had randomly arrived was because they were out this way seeing someone else who was only about 15 minutes away, and so decided to come straight on and see me. I still don't understand a) why nobody called this morning, and b) why they couldn't have called when they were 15 minutes away so that I would have had at least had a tiny bit of advance warning. So they literally knew absolutely nothing about me, my history, when I was referred to them, why I was referred to them, how long I had been under mental health services, what my diagnosis was - nothing. I know I complained yesterday about the crisis team not reading your notes properly, but this was a whole new level - they had to ask things like how old I was, and when had I been referred to them. I said I had been referred Friday by my GP, and they asked why he (she's a she but I didn't bother correcting them) had referred me - was it because I was feeling low, and I said it was because of suicidal thoughts, which he loudly repeated, which really set off my paranoia. He asked if the feelings had changed and I said no. I think it was at this point they told me they knew nothing about me and started asking things like how old was I, and did I work, and what had I done education wise etc, and how long had I been involved with mental health services for, and why I was originally referred, and about previous suicide attempts and hospital admissions etc. They were also in agreement with the people that I saw yesterday in that I should see a psychiatrist, they said urgently, and that they would speak to their team psychiatrist tomorrow, and I would either see them or Dr E as soon as possible. I don't know if I will have any more visits from the crisis team, because they said they would speak to L tomorrow, and I am guessing she will probably not be too keen on me seeing them. He asked if I felt able to keep myself safe today and I just kind of shrugged. Saying yes would have been a lie, but I didn't feel able to say no when I was feeling so paranoid with my parents being in the house etc. He asked if I would be able to call them if things really reached crisis point, and I once again explained that no I wouldn't, because if things were any worse then I wouldn't want help. He asked if it would be ok if someone called me this evening, and would I be able to tell them if I was feeling worse, and I said that would be ok.

I am feeling really confused. I don't know what to do. I don't know if I should wait for the call this evening and try and tell them how desperate I am, or whether I should call them before then, or whether I actually don't really want to speak to anyone or want any help. I am frustrated with the way today turned out. I just felt so uncomfortable and I really had intended to try and be really blunt about how I was feeling, and I just couldn't, and now I feel really hopeless and just don't know what to do. I wish they had bloody called this morning like they had arranged to do rather than just turning up with no notice.

Referral to crisis team

I had an appointment with my GP this afternoon, as I mentioned yesterday. I had quite mixed feelings about what to say to her. I didn't know how much to say. I didn't know if I wanted help or not. I didn't know whether I would be able to get help or not, even if I did ask for it. I just knew how suicidal I was feeling, and that if I left there without asking for/getting support then I would not get through the weekend - it just wasn't going to happen. Within a couple of minutes of me going in she commented that I seemed to be having trouble with my concentration, which I am. I keep losing my train of thought in the middle of a sentence and then just kind of drifting off and forgetting what I was answering. I can't really remember the appointment very well, I don't remember what order things happened, or even what she asked really. I know I was in there for quite a long time. I told her how bad my sleep was, and she asked if I had any of the sleeping tablets left, and I said that I did but they didn't help, which was why I hadn't been taking them really. She had received a letter from the psychologist that had been sent to L that she had been CCed on, and asked me what that was about. I told her I had an assessment with the psychologist and she had put me on the waiting list for CAT. She asked if there being a psychologist there was new, as she never seems to have any patients who are seeing them, and I said that it wasn't, but since there is only one part time psychologist in the team not many people get to see her. She asked what CAT was, and how it was different from CBT, and I tried to explain, but my mind was really wandering, so she is probably none the wiser. She asked how long the therapy lasts for, and I said either 16 or 24 sessions, and she asked how long the waiting list was and I said up to 18 weeks. She got very frustrated by that - she said how ridiculous it is that there are such long waiting lists for things like that, particularly when the government are so keen to get people back to work and all that sort of thing - she said it really winds her up that mental health services are so underfunded. At some point I started getting slightly upset - I wasn't crying, but I knew that if I tried to speak I would start crying, so I just sat there trying to breathe for a minute. She was very sweet and asked what the matter was. When I finally felt like I could speak without bursting into tears I told her that I was just really struggling and feeling really bad. She asked how long I had been feeling like this for, and said (as predicted!) what a shame it was when I had been doing so well. I said I was just feeling really awful and the suicidal thoughts were really strong, and she said how I have felt like this before and that I know it will pass and so I could get through it, and I said that I didn't want to, I just wanted to die. She joked that if I said that she would have to suggest I started cross stitching again. She asked when I was seeing L, and I said that I was due to see her Tuesday. She talked to me for quite a while asking if I had any plans over the weekend, and if I had any friends I could see or talk to or anything who were supportive. She was very supportive and kept trying to encourage me that I could get through, and said to try and find something I could do over the weekend, and then go and talk to L on Tuesday, and that I could see her again sooner than usual if I felt I needed to, and that she was really sorry I was feeling so bad, but that it would get better etc. I didn't really know what to say - I find it really difficult to be totally blunt about how bad things are when I am actually speaking to someone, and I just felt so drained, and like I was going to burst into tears, so I said goodbye, and got about 2 feet outside her door and turned around and went back in and said I really didn't feel able to get through the weekend. She asked what I would like her to do, and I said I had no idea, I just couldn't cope. She asked if I had the out of hours number, and I briefly explained the mess of when I tried to call a couple of weeks ago. She said that was ridiculous, and that she was going to call the crisis team and ask them to make contact with me over the weekend, and that hopefully having that support would make it easier to keep going. Overall she was very supportive, and I felt like she actually gave a shit about what happened to me. Obviously mental health isn't her area of expertise, but when I am truly in crisis she does seem to try hard to support me. She spent a long time with me today - I must have been with her for about 40 minutes, and she did genuinely seem to care.

About an hour later I got a call from the crisis team. To be honest I wasn't really expecting them to call today - I thought it would be tomorrow, so I was quite surprised. I spoke to a man whose name I can't remember who actually seemed perfectly nice. Initially I thought it was going to be one of those quick 'oh great, we've had a Borderline referred, better give them a quick ring' calls that I have had in the past. He did things like asking if this was the first time I had felt like this (I always wonder why they ask things like that when they quite clearly have your notes in front of them) and then asking what had helped me get through in the past, or if after a while I just started feeling better, and when was I next seeing L. I said that nothing really helped, but that after a while it would start to get a bit easier. He said the stuff about how if I have got through it before then I could again, and I said that I didn't want to. That I was sick of getting through a really horrible patch just for another one to come along, and that I just didn't want to be here any more. I also said that this was actually the worst I had felt for quite a long time - that the suicidal thoughts were stronger this time than they have been for a long time. He asked how long, but I didn't really know - again, my whole conversation with him was rather stumbling and confused as I just couldn't think properly. I said I have been feeling bad for years now, and things never get any better and that I have just had enough - that I don't want to be here. He asked if I had any plans regarding suicide, and I said that it was all I could think about. He asked what I would do, and I said that I didn't want to say because that makes things rather awkward (as in my experience they have then merely attempted to take away whatever method I say I am planning, which doesn't solve anything, as I am still left with the feelings). He asked if I had the means to carry it out, and I said yes, and that if I couldn't use one method then I would use the other that I consider. He asked if I would call someone if I felt I was going to act on my thoughts, and I said no - that if I was any closer to suicide then I wouldn't want to speak to anyone because I wouldn't want to be stopped, and that it was difficult enough to tell Dr O how I was feeling, but that if I was about to do something then I would not call anyone, as it would seem completely counterproductive - if I was any more suicidal than I am now then I would just want to die, I wouldn't want to talk to someone. We talked about my sleep, and how the nights are when I feel most unsafe, as I know I have quite a few hours when my parents are asleep, and so it would be quite a long time before anyone found me etc. He asked about plans for the weekend etc, and I said I didn't have any. He said that the crisis team could visit me tomorrow, but that I needed to commit to keeping myself safe and would that be ok. I said I couldn't promise that - that I could try, but I couldn't give him a guarantee, because I didn't know for sure, and there would be a chance I wouldn't be able to. He asked why not, and I said that if things got too overwhelming then I couldn't be sure I wouldn't act on the thoughts, and he said that he was hoping that if they were seeing me and giving me support then it would stop that from happening, but that he understood and wouldn't ask me to promise, and that they would come out to see me tomorrow. He did ask me more, but I can't remember, and I can't remember the order of most of the conversation. At first I felt like he was just going to make a quick five minute phone call where he would ask when I was seeing L, reassure me that I had got through times like this before, and say to talk to L about it when I saw her, but actually he talked to me for a long time, and was pretty thorough and reasonable. He said they would come out and visit me tomorrow, but that if I needed to speak to someone before then I could call, and he said that he would give me their number, which he shouldn't really do until after they had seen me and assessed me, but that if I needed to call then to phone that, which goes through to a call centre where you leave your name and number, and someone would then call me back as soon as possible. So I have them coming out to see me sometime tomorrow, which I am quite nervous about. I would actually really like it to be him that came out, but that is very unlikely. It's funny, as usually I am much more comfortable with women than men, but the women who work for the crisis team seem to be either patronising, dismissive, intimidating, or a combination of the above, whereas there have actually been a couple of men who have seemed very reasonable. I am pretty much expecting it to be a couple of the scary women (there is one in particular who I have seen several times who I find really intimidating so am really hoping it isn't her) who will come out and either be very dismissive and say that I seem to have suicidal thoughts frequently and that I can get through this and to talk to L on Tuesday, perhaps also breaking my confidentiality by talking to my mum and telling her to confiscate all pills and dressing gown cords etc as I am a suicide risk, as that tends to be my experience with the crisis team, but I am really hoping it isn't like that. It is over two years since they last came out to see me etc - I think I have been referred one other time since then, but someone just spoke to me on the phone and decided I would be ok, and I have been assessed by them several times in A&E, during Summer '09, but I haven't actually had a visit from them for over two years, and I am a bit nervous. I hate the way they always visit in pairs - it feels really intimidating. I just really, really hope that it is someone who actually takes me seriously and tries to help, rather than just dismisses how I am feeling in the way that they so often seem to. I tried to be really honest with the man on the phone, as I figured it couldn't do any harm - it couldn't take suicide away as an option, but it might get me some support. I hope that I can do the same tomorrow, and that they actually take me seriously like he seemed to. I suppose if they don't I won't be any worse off than I would have been had I not seen them though. And it might help. The difficulty is, that as I explained to him, it is the night time that I feel most unsafe, and even if they are doing daily visits, they can't be here now, when the thoughts are at their strongest. But I will just have to see how it goes.

I have tried

Firstly, thank you all so much for the comments on my last entry. You were all so supportive and caring, and it really did mean a lot. Quite a few people suggested I should be in hospital, or go to A&E, and a few people asked why my care plan says to avoid being admitted. That is kind of difficult to explain, partially because I don't completely understand myself. This entire paragraph will attempt to explain, and is long, so please skip to next paragraph if this doesn't interest you! I do know a few reasons why L wants to avoid it, and therefore put it on my care plan, and I can completely see where she is coming from in that sense. There is still a lot of stigma surrounding BPD, and this is apparently pretty rife both amongst the hospital staff and the crisis team staff. I haven't been in hospital since being given the BPD diagnosis, so can't comment on that, but from my experience I would agree that the crisis team seem to have a poor attitude towards PDs - when I switched GP a couple of years ago which put me back under this trust for Mental Health, I was seeing the crisis team (the GP referred me) and they said they would continue to see me until I was taken on my the CMHT, which was likely to be a few weeks away still. Then one day they had contact with the old CMHT, were told I had a PD diagnosis, and when they visited that day their attitude was completely different, and they didn't see me after that, despite it still being a couple of weeks before I was due to see the CMHT. I can only assume that was down to seeing a PD diagnosis, rather than the depression etc the GP had discussed when referring me. It didn't seem to matter that I was still feeling very suicidal and had attempted suicide only a month or two earlier - they just dropped me. So I could see that attitude in the crisis team then, and it is apparently equally bad amongst the hospital staff. During summer 2009 I ended up presenting at A&E three or four times due to suicidal thoughts etc. Despite making my feelings and thoughts known clearly, I was sent home every time, after perhaps a 10 minute chat with the crisis team, who would generally then speak to my mum and tell her to make sure I didn't have access to any tablets or dressing gown cords etc, as I was suicidal. One time she asked them to admit me as she said she couldn't cope, but I was still sent home. At that time I really was not well at all - I was possibly a slightly lower suicide risk than I have been at some other times as I was just so confused etc. I wouldn't go anywhere, even outside of my room, without my teddy bear, as I thought that he could protect me and I thought people wanted to hurt me. I didn't trust anyone, even my family. I wouldn't put the teddy bear down under any circumstances. I spent the whole time crying, I was possibly a bit delusional, and I was also having suicidal thoughts. I sat there crying, clutching my teddy bear (yes, I was 23) telling them that I wanted to die and that I was going to kill myself but that people were trying to get me. I was still just sent home with no follow up, despite my mum asking them to admit me. That was the last time I went to A&E, and the last time I saw anyone from the crisis team. I have no trust in the crisis team - I don't feel like they care if I live or die, except for any inconvenience I might cause by dying, but luckily for them I have a BPD label, and therefore if I did successfully commit suicide after seeing them they wouldn't have to explain anything too fully, because they can always say with BPD that there is constant risk and therefore you can't be kept safe, or something along those lines. So essentially my diagnosis is a major reason why L doesn't think hospital is appropriate - not because she has a problem with it, because she is one of the few professionals I know who gets really angry about the way people with BPD are treated in services etc, but because she doesn't want me exposed to the type of attitude that so many of the acute services staff do have. I think that is a valid point, and I can understand the reasoning behind it. Another reason is that she thinks that the vast majority of times hospital actually makes people worse rather than better. Therapeutically it has no value, as there is no therapy there, and so unless it is essential for medications to be altered or something, she thinks it rarely helps. Again, I have to agree that there is no therapeutic value - it is essentially somewhere to keep you safe until you can be safe at home - for that reason I think it can have value, but she has pointed out in the past that if someone is determined to kill themselves then they will do it wherever they are, and that people do successfully commit suicide in hospital. Another reason is that she thinks it is really important that I get through bad patches without hospital or crisis team intervention, to see that I can do it. She doesn't want me to get reliant on hospital, and feel like I need admission every time I feel suicidal. Again, I think that is a good point, and it is certainly something I have seen happen, both with friends in real life, and on blogs I have read. If you don't start learning to cope with the feelings outside of hospital, then you never will be able to, and she doesn't want me to be a revolving door patient. I really do understand where she is coming from with this - I don't want that either, and I know that even in the past year for example, there has been more than one period where I have felt bad enough that I haven't felt safe, and other care coordinators perhaps would have had me admitted, and yet I have got through them. However, I also know that if I look back at my history, there have been two genuine suicide attempts, three years apart, and both times I was honest about how I was feeling beforehand and tried to get help, but couldn't. There have been other times when I know I would have acted on the thoughts had I not received the extra help that I had at the time, whether that be from the crisis team or hospital admissions. So I suppose that is a kind of risky strategy in that most times, yes, I will cope without hospital, and that is obviously a positive thing, but there will also be times when I can't, and if more help isn't available then that could lead to a suicide attempt, which could of course kill me, as that is the intention. So basically they are the reasons why my care plan says to avoid admission wherever possible.

For those who suggested that perhaps I hadn't been able to explain fully how bad things are - I do think that is something that is difficult to do, and that I am not always able to do in person. However, the day before I am due to see her I always email her everything I have written since the last time I saw her, which is primarily what I write on this blog. It is edited slightly - sometimes I will write things in what I send to her that I won't post on here for various reasons, and there are things I write on here that I don't send to her. But not anything to do with my mood or thoughts - all of that remains unedited, and so essentially she gets to read everything that people who read this blog read. The things I don't send are for example if I have discussed what happened in an appointment, I don't bother sending that to her because she already knows. In general though I am very honest, and I do send her things that I find difficult to imagine her reading, which is why I try to edit as little as possible, or I would end up cutting a lot of things out, so for example I leave in things like my views on the mental health service, and when I don't feel like I am getting enough support, and when I feel like she has let me down or isn't there for me etc. So it is very honest, and is difficult to do, but I know that the more she knows the more she can help me. So whilst I may not always express quite how bad things are in person, she reads virtually the same as all of you read, therefore I don't think I can really make things any clearer. Seemingly what I write here is enough to concern people at times, judging from comments, and she sees the same thing. I think the fact that a lot of times I have managed to cope, leads her to have more belief in my ability to get by than I have, and means that even if I say outright that I can't cope, she generally believes that I will manage to. I appreciate that she has that belief in me, and I am more pleased than I can express that she isn't like my old care coordinator, who sent me to A&E if he thought there was any chance of me acting on my thoughts, and also insisted on breaking confidentiality and speaking to my mum if I mentioned the word suicide, as that means I am far more honest with her than I could ever have even considered being with him. However, it does sometimes mean that there are times like now, when I don't feel able to cope, and yet I am left without any support, and I honestly don't know how to deal with that.

A couple of hours after posting last night, when I had read the first few comments on the post, I decided to email L. I didn't know what to say. So I said that. I then rambled a little about feeling like things were getting worse every day, and I really felt like I needed more help if I was going to get through this, but that I didn't know what or if it was an option, but that I felt like I needed to ask so that I could tick it off in my head as trying to get help, and then went on to say I had attached what I had written in the last week (basically sent everything from last Wednesday to last night's post - I think the only edit was describing what happened in the appointment with the psychologist, because she will already have been told about that. I left in everything else, including all the stuff about not feeling like I was getting enough support, and that I feel like services assume I will just get by because I usually do. I then apologised multiple times for being a nuisance and said how desperate I feel, and I think that was about it. Except it somehow took about three times as long to say. Just add some more confusion in and you get the idea. I then sent it and within about 10 minutes wished I hadn't, as it seemed pointless and kind of scary, even though I trust her. I nearly sent another email telling her to ignore the last one, but I thought she would probably read it anyway, and that it might then look a bit manipulative or something so send a second one saying not to look at the first one. So I left it. I haven't heard anything. She didn't reply or phone. I don't know if she wasn't in work, or if she was too busy to contact me, or if she didn't see the point or what. But at least I have tried. She now knows exactly how I feel, or as much as I feel able to put into words anyway, and I have actually directly said that I need more help. If I can't have more help, which I suspect will be the outcome if she does get back to me, then at least I have tried, and so kind of feel like I have done everything that I can and explored all options, which is what I always say I feel people should do if possible. But I have tried.

Invalidation and anger

Today has been difficult. Last night was difficult too actually. I have been feeling more and more strongly that I don't want to be here. I feel completely alone - I know I have the support of people on here, but that is different to real life support, and actually what I feel like I need at the moment is professional support, and that is what I am not getting. Last night I was actually feeling really tempted to discharge myself from mental health services - sometimes it feels like an appointment for an hour once a fortnight is worse than nothing at all, because when it is helpful I still leave feeling hopeless, because I know it is 2 weeks before I will get that again, and then there isn't time to talk about everything I feel I need to talk about - I found that even with weekly appointments, so fortnightly are even more difficult, and then even when I am really at crisis point I can't get any more support, so it all seems kind of pointless. Fortnightly sessions feel a bit like 'so here's what you could have won!' L has always been very supportive of me, and I know I have been lucky to have her, but I almost feel like she has given up on me or stopped caring or something. Either that or she thinks I am making up these feelings. I am not sure which is worse. But either way I don't feel supported at the moment. So I did consider contacting her and asking to be discharged, but I decided against it. She would probably have suggested we discuss it when I am next due to see her, in a week and a half, and by that time goodness knows how I feel or what position I will be in. I could be dead, or I could have attempted suicide but failed, or I could be feeling differently about things. So I suppose essentially it seemed pointless to ask for discharge now, when I am not even due to see her for a week and a half. I am just really struggling with the lack of support when I am feeling so bad. I suppose I just feel abandoned, and like nobody actually gives a shit whether I kill myself or not, which in a way is a good thing, as it makes me feel less guilty.

This evening was really difficult. A friend of my dad had asked him to go to a quiz a couple of days ago, but they only needed one for their team, so my mum and I couldn't go. My mum was going out with a friend, and asked if I wanted to go with them, but I didn't. Anyway, my dad phoned me at 5:45 and said he had spoken to his friend and there was room for me at the quiz after all, as someone couldn't make it, and that we would need to leave at 6:45. I wasn't actually sure if I wanted to go by that point, as I was anticipating a night here on my own, but I also knew that with how I was feeling that probably wasn't the most sensible option, so I agreed to go. The trouble is, it wasn't giving me nearly long enough to get ready - it was about 6 when I started to get ready, and I had a quick shower but didn't have time to wash my hair, so just straightened it instead. That didn't take too long. Getting dressed is another matter however. I find it incredibly hard to know what to wear if I am going anywhere other than an appointment or rehearsal, in which case I either don't give a shit what I look like, or wear dance type clothes. When I am going anywhere else getting dressed is an incredibly stressful and time consuming process. I put on a skirt, top, and cardigan, then decided the tights were no good, then decided it wasn't the tights that were the problem - it was my huge legs. So off came the skirt and cardigan, and on went skinny jeans and boots and a long cardigan. I decided my legs still looked hideous, and was getting really quite upset and crying by this point. Told my mum I wanted to stay home and that I couldn't get ready. All along my mum had been trying to be helpful, but was actually making matters worse, by saying that I was being ridiculous and my legs looked fine, and that the jeans looked fine, and nobody else would look at me and think my legs looked awful, and that I was making my dad late (which I was), and I ended up yelling at her that I felt hideous and I didn't give a shit what other people would think - I couldn't go out feeling hideous. Was sobbing uncontrollably by this point. Took off the jeans and cardigan and tried on a different skirt, but still didn't feel comfortable, and didn't have a cardigan that would go with it so would have been cold. She kept on and on, and it felt like absolutely everything I said she was just dismissing and invalidating, which is an ongoing theme, and I totally snapped in the end and screamed that she was being really fucking invalidating, to which she replied that she didn't even know what that meant in this context, and so I said that she was just dismissing and ignoring all of my feelings, and she said that was because they were stupid, and I said (when I say I said, I mean I screamed) that they were real to me, and that she was constantly invalidating my thoughts and feelings, and that actually that can be a major contributory factor to BPD. I wished immediately that I hadn't said that, because I never want to make my parents feel bad, or like they are to blame for my problems - partly because I don't think it is fair to blame someone else, and partly because I don't want them to feel guilty, even when I do think they have contributed to how I am now. So I felt like a complete bitch, and was in a complete state, crying hysterically and hyperventilating. I said (cried) that I couldn't go out and I needed to stay home, and had put my comfy jeans on by that point, not with the intention of going anywhere. My mum said I looked nice in my comfy jeans that I had on and that I should go like that. I just couldn't stop crying. My dad came upstairs then and tried to calm me down a bit - he asked what the matter was and I said (cried) that I felt hideous in everything and I had made him late and I couldn't go anywhere, and that it was my mum's fault (unfair I know). He said we weren't too late, and that I looked fine how I was, and I didn't need to dress up or anything and that I needed to just calm down. I think my mum was also quite worked up by this time as she said what I needed was a slap, and at that point I completely lost my temper and screamed that I was going to kill her and my dad had to hold me back from going into her room after her. I don't think that I ever would be really physically violent - I have been known to hit my dad when I have got really angry and worked up, but it is generally when he has intentionally wound me up, which he has a tendency to do it, but I don't get any more violent than that - I have grabbed a knife and said I am going to stab him in the past, but I am certain I would never do anything like that - my anger just gets out of control occasionally and I say things that I don't mean, like I did tonight. I then said that she was a fucking bitch and cried some more. After a minute my temper disappeared and I was just back to being upset. My dad said he really wanted me to go with him and I calmed down a bit, although I was still sobbing, and said goodbye to my mum, and we left. I then sat in the car crying and was talking to myself a bit, but my dad managed to get me to stop. I decided I needed a Diazepam a minute or two after we had left, and looked in my bag, to find that I had grabbed my Zopiclone instead of my Diazepam (and very nearly taken one - they are the same size tablets, and apart from the writing, the blister packs look identical) and so I then had a panic attack and said I had to get out of the car and I would walk home because I needed my Diazepam. A moment more of rooting in my bag produced some Diazepam though, and I took one, and after about 10 minutes had managed to calm down enough that I was just sobbing quietly, and a little while later I started to feel a bit better, and was relatively calm by the time we arrived.

The actual quiz was fine. I only knew my dad's friend on our table, as did he, but the other people all seemed nice. I answered a reasonable number of questions, although not nearly as many as my dad - he is very good at quizzes. Food was an issue. There was a Ploughman's included in the ticket price, so there were baguettes and cheeses on each table, and then the people on our table had brought lots and lots of crisps and nuts and things with them, and when there are things like that out I just can't stop eating, so I ate all evening, and was feeling worse and worse about myself. Then finally there was this chocolate cake thing that someone had brought, and I had a piece of that, and it was incredibly rich (and something has to be really rich for me to say that as I have a very sweet tooth!) and I just couldn't cope, and I ended up going to the toilets and purging. That is the first time I have purged for ages - it has been months since I last did it, but quizzes are a real trigger for me where that is concerned - there are always lots of nibbles around, and I have no self control where things like that are concerned and so just keep eating, and then feel terrible and go and purge as much as I can. It was also at a quiz that I first ever purged, so I guess they are one of the least safe places for me in that respect. I hate myself for the amount I ate, despite purging. And even though it is now 3:30am, and so it was hours ago, I still feel sick from it. I am feeling really shit about that - my weight had been slightly down this morning, and it made it that tiny bit easier to get through the day, and now it is going to be way up and I just can't cope with something else going wrong. So it was a really bloody hard night. Although out of 15 teams we did win the quiz, and so my dad and I came home with a bottle of champagne and a box of chocolates.

I am feeling really guilty about the things that I said to, and about, my mum. I feel like a terrible person. When I lose my temper I just seem to lose all control, and when I am very upset and then she says things that upset me more I just snap. My dad does it too, but kind of intentionally - he does wind me up on purpose sometimes. Strangely I don't think he means to upset me - it is like he doesn't realise that what he is doing or saying is really upsetting me or making me angry, despite the fact it happens on a semi-regular basis. I think he just genuinely doesn't realise how his words affect people. I suppose it is just a complete lack of tact, and not thinking before he speaks, and an almost childlike sense of him thinking something is fun, even when the other person quite clearly isn't enjoying it. And so I do get really furious with him. My mum is different. She means well, and she tries to help, but I really do find her very invalidating a lot of the time, and when I am already upset I just can't cope with it. My mum and I bicker a lot, but it is very rare for me to lose my temper with her to the extent that I did tonight. In fact I am not sure that I ever have - I have always had the self control before not to point out that there may be a link between her behaviours and some of my problems, and I lost that tonight, and feel really guilty for doing so, as I know it will have upset her, and that is the last thing I want to do when she does so much for me, and tries so hard to support me. I think I am just feeling so awful at the moment that it really isn't going to take much at all to flip me over the edge in the way that I did tonight. And the worse I feel the more I hate myself, and the more self critical I am, and the more irritable I am, and therefore the more frustrating I am to my parents, so it does tend to be that the lower my mood, the more we argue, which then makes me feel worse and more suicidal, and acts as proof to me that they would be better off without me. I am really not in a good place at the moment, and I don't know what to do. Suicide looks more and more appealing every day.

Assessment

I had my assessment appointment with the psychologist today. It was fine. I feel like my brain is quite slow because of how I am feeling, and so I think it probably took me quite a long time to answer some of her questions, although I am not really sure as my perception of time seems a bit wonky at the moment. Anyway, she was very nice and friendly. She didn't ask about my history at all - she asked why I thought I had been referred, and then asked what my current problems are and what I would want help with changing in therapy etc. She asked how I felt about therapy, and if I felt like I wanted it at the moment. I said that it was really difficult to answer that, because a month ago I would have said yes, but that at the moment I was feeling very suicidal and didn't see a future. I said that I didn't want to waste her time by saying I was interested if I was then going to go home and kill myself in a few days. She said she would offer me CAT, and talked a bit about it, and asked if I would have interested in that if she had asked me a month ago rather than today. I said that a month ago I would have said yes, and so she said that she would put me on the waiting list because with how I am feeling at the moment I wouldn't really be able to make a decision. The waiting list is up to 18 weeks, and therefore probably longer than the therapy, as that tends to be 16 weeks, although she said it would possibly be 24 weeks. I was getting a bit emotional at the end of the appointment - I think I was just feeling so hopeless and overwhelmed, and I was starting to feel a bit teary, but I managed to hold it in. I am not good at showing emotion.

I had quite a lot of time to hang around in town before and after my appointment. There was about 45 minutes before and I went into Costa and tried to read a book, but I couldn't concentrate - the words were swimming around on the page and I couldn't concentrate and just ended up staring into space. Reading really isn't working for me at the moment. After the appointment I had to wait for about an hour before I could be picked up and I went and sat in the library. I was somehow there for an hour and yet it felt like 10 or 15 minutes - I was just in a daze. I didn't even bother trying to read, I just sat there. I think I am dissociating quite a lot at the moment - time just keeps disappearing without me being aware of it.

I am struggling a lot. I made it until today, which was what I said I would do, and I went to the appointment. It was fine, and the psychologist was nice, but I am now back in the position of feeling very depressed and suicidal, with just fortnightly appointments with L to get me through, and a 3 or 4 month waiting list for therapy. Essentially that does not feel like a realistic option. It is now nearly 2 weeks again before I am due to see anyone. To be honest even if I had more help I don't know whether I could get through this, but it certainly doesn't feel like a possibility as things stand. I know that it is my life and I have to take responsibility for myself, but when I feel this bad the only way I feel able to do that is by telling someone how bad I am feeling and trying to get help, which is really hard to do, but is all I feel able to do. I do find it frustrating that it is always just assumed I will be fine and manage to get through. There have been a lot of times when I have been desperate and coped, but there are other times when I haven't. I think because it has been over two years since I last attempted suicide there is just an assumption that I will be fine. The last time I attempted suicide it was actually very similar, although that time it had been even longer - it was over 3 years that time, and again actually I was only seeing someone fortnightly, and that person wasn't even remotely supportive when I did see her, and completely ignored how bad I was feeling. I don't feel like L is ignoring how bad I feel, but I do just feel like there is an assumption I will just get by because I usually do, and sometimes I just feel so desperate, and like I need more support to cope, and when I can't get that it makes it even harder to find the motivation to keep fighting - it feels like they don't care enough to support me, so why I should I keep trying so hard when I don't want to be here? I just don't know what to do.

Frustrated

I am really struggling. I saw L this morning, but to be perfectly honest I don't feel like it helped at all. I don't feel like I really ended up talking about anything I feel like I wanted or needed to - it just seemed to go off in a direction that may have been helpful for her in understanding more, but didn't do anything to help me. I wish I could re-do the appointment and somehow change it. Although I don't really know what I did want to talk about. I just feel frustrated that I have had the one hour in a fortnight when I could talk, and I wasted it. Although maybe I would feel like that regardless of what we had talked about. I don't know. I don't know what I wanted her to do, but I suppose I just felt like I needed something. She just made an appointment for a fortnight's time like usual. I suppose I have this appointment on Thursday, but that is just an assessment, that isn't going to help - it will just be going over my history. I will still wait until then and go to the appointment, but I am not feeling hopeful in any way. Quite the opposite to be honest. I am exhausted.

Decision

So I suppose today has been vaguely productive, even if I have felt shit. I showered. It is so weird the way you don't realise how disgusting you smell until you are clean. It's lucky I hadn't left the house since Monday. Something as simple as showering really shouldn't take so much effort and feel so difficult. People do it every day. I do it every day when I don't feel like this. I never find it difficult. Then full blown depression hits, and it suddenly seems like a completely pointless, and rather strange thing to do. So what if you stink and look like shit? It involves being out of bed for more than 5 minutes, and therefore absolutely is not worth the effort. In the end my mum tells me how revolting I am and makes me shower, and I then realise that I am indeed revolting, but still don't actually care. So anyway, I showered and washed my hair. I am sure that I must deserve a medal of some kind - I managed to do something that the rest of the population do daily without even thinking about. What an achievement.

I also had rehearsal. I managed to make myself rushed and slightly late by getting up too late, which was because it was 7:30am before I got to sleep, so I fairly naturally then didn't want to get up. I then spent half an hour persuading myself to get out of bed, then spent over an hour showering, throwing on the clothes from the top of the pile, and drying my hair for 3 minutes. Oh, and cleaning my teeth. I seem to do everything in slow motion at the moment - I am still trying to work out how those things took over an hour. I didn't spend time wondering what to wear - I just threw on some dance trousers and a top and cardigan that were conveniently at the top of the pile because they were what I wore last time I left the house. The cast probably think I only own one set of clothes.

Went to rehearsal. It wasn't quite as painful as last week, but I think only because I was there for an hour less. I still spent the whole time wanting to go home. Felt useless because I hadn't warmed up my voice properly (ie I had sung for about 5 minutes in the car on the way there) because I just couldn't be bothered, and so I sounded like shit. Typically the director wanted to listen to me sing my biggest solo for the first time. Never mind. Sung a bit more, pranced around a bit, said a few lines, had a few kisses, came home. I think I must have been functioning on auto pilot, and at least partially dissociating, because there are big chunks I don't remember, and one time I remember starting the number, and then realising we had finished, but not being aware of anything in the middle. My concentration is all over the place. I have to go to another rehearsal tomorrow night, after ballet. That is a full cast rehearsal, whereas today was just me, the male lead, the director/choreographer, and the musical director, so I need to try and be a bit more focused tomorrow or I will probably end up looking like a complete idiot. Again, I don't want to go, but it would fuck up the entire rehearsal if I wasn't there, so I don't have a choice.

I made a decision today. That sounds a bit monumental doesn't it? And it isn't, or not really anyway, given that I quite frequently change my mind. But I realised I have been a bit hypocritical lately, because I have been planning to kill myself, but allowing myself to forget something I have said to friends when they have been feeling suicidal. That I think suicide can be a valid option once you have tried all other options that are realistically open to you at that time, but not before then. On Thursday I have an assessment appointment with a Clinical Psychologist whom I have never met before. I have no idea if she would be able to help me, and to be honest at the moment I still feel like I would rather be dead regardless of whether I might start to feel better at some point, but it is something that is currently an option I haven't explored, and I think I would be very hypocritical if I were to ignore that, so I decided that however bad I feel I must at least keep going until then. Deciding not to kill myself within the next four days probably doesn't really sound like a very big deal, but it feels like it to me, because I am just feeling so terrible. So I need to really focus on getting through the next four days. After that I have no idea what will happen - I am not going to commit to anything further ahead than that, because that would feel impossible right now, but at least I am making the effort to go to the appointment and meet her etc. So I just have to get through tomorrow, when I will probably sleep the majority of the day, then have to go to dreaded ballet and rehearsal in the evening, then Tuesday I am seeing L, but I am not sure what I can do after that. My mum has a hospital appointment, but I find hospitals kind of triggering at the moment - they make me want to kill myself even more than I do usually. I suppose association of ideas. Anyway, then Wednesday will maybe be another sleeping day, and then I will have to go to another rehearsal. And then it will be Thursday and I will see the Psychologist. And that is as far as I am going to think or plan, because it gets too overwhelming after that. It all feels quite scary and difficult - even just thinking about being alive in four days time is hard, and I really wish I could get out of rehearsals and things, but realistically I can't without getting a lot of very awkward questions and inconveniencing a lot of people, and even if I could it wouldn't help really, because it is my head I need a break from, and I can't get that any more at home than I can out - it is just easier being at home because I don't have to hide behind a facade all of the time. I still desperately want out. I am exhausted. But I will stick to what I believe and at least go to the appointment on Thursday. Obviously I know nothing will change then, and that she won't be able to magic me better. But at least I will be going and meeting her, and getting an impression of what she is like. If I still want to kill myself after that then I think it is pretty much fair game - no big dates coming up for a few weeks, not too close to the show that I can't be replaced, no particular reason stopping me that I can think of. But I won't make a decision before Thursday, or I will try not to. I can't not see suicide as an option, because it is basically, but I am seeing it as an option I can explore after Thursday if I want to, not before. That's not something I can do long term, or keep doing time after time for various reasons, but I think I can do it for the next few days. I suspect this entire paragraph would make no sense to anyone but me, but I understand how my mind works. Or I do some of the time. Sometimes I find it utterly baffling.

Inside I'm screaming

Things aren't getting easier. I am still feeling really desperate, and really like I am going to fall off the edge of this cliff I am clinging on to by my finger nails. Tonight I made the decision to call the out of hours number. This is not something I usually do. I have called before, but I don't remember the last time, and I have called perhaps once in the last year. I find it really difficult to phone and say I am struggling - I even find it hard to call L when I am going through a bad time, as I just don't know what to say, and it is like my entire vocabulary disappears from my body apart from a few words like 'I'm not feeling very good' or something equally ridiculous and meaningless. But when I call and speak to L, I know the sort of thing she is likely to say, and it is safe - it doesn't feel scary, apart from my dislike of phoning anyone, and the knowledge that I won't be able to express how I am feeling. Calling the CMHT when she is not there is more difficult because I don't know who I will end up speaking to, and it makes me far more anxious, and so I have to be more desperate to do it. However, once I know who I am talking to, again I know what they are likely to say, and what I feel able to say as a result. For example if I end up speaking to my old, shit care coordinator, I know not to mention the word suicidal, even in passing, as I will be told to go to A&E. If it is one of the women I can say pretty much anything, and won't be told to do that, but they will almost certainly suggest I go for a walk or have a bath, and ask when I am next seeing L, and tell me to wait until then and talk to her about how I am feeling. Calling the out of hours number is a whole different situation, as I don't know anybody, or at least occasionally I have spoken to someone who has said they have talked to me before, but I never remember. So I find that a really difficult and scary thing to do, which is why I ring so rarely - I have to be really desperate to even consider it, and I have to feel right on the edge to actually call. I don't know what I expect them to say - I know they can't change how I feel, but a couple of times I have spoken to people who have been really helpful and understanding and who have helped me - other times it has been completely unhelpful, so it is pot luck really. Anyway tonight I decided I had reached that point and so called the number I have been given, which goes through to the local psych ward - you can't call the crisis team unless you have been referred to them, so if you phone out of hours you speak to one of the psych ward nurses. I rung and asked if there was somebody I could speak to, and she asked if I was a service user, and said I needed to phone the main hospital switchboard, who would put me through to the crisis team. So then I had to try and make myself make another phone call. Calling the crisis team is scarier than calling the ward for some reason. Anyway, I rung the main hospital switchboard and asked to be put through to the crisis team. She asked for me name and asked if I was a doctor or professional, and I said I was a service user. She said that they can't put service users through to the crisis team, only professionals, and that I needed to call the psych ward. I said that I had just done that and been told to call them. She sounded slightly confused and said she didn't know why, as they used to be able to put people through to the crisis team, but now they had to give people the number of the ward. She gave me the number, which was a different number again - I now have 3 numbers for the psych ward - there is the one on the trust website, the one I was given and told to use out of hours that I have called before, and now the one that I was given tonight. At this point I gave up. I couldn't face making another phone call, when I had already gone through the anxiety of calling the ward, to be told I needed to call the switchboard and put through to the crisis team, to be told I needed to call the ward, who would probably have given me yet another bloody number. So I just gave up. I am pretty unimpressed with the quality of the out of hours services in the trust though. Other people seem to just be able to call their crisis team out of hours. In fact, I could in the other trust I was under. It is frustrating that on an occasion when I am really struggling, and could really do with talking to someone, and I actually manage to pluck up the courage to ring, I can't actually get through to anyone. Ironically I received a Service User Questionnaire from the MH Trust in the post today. I may not be overly complimentary.

I don't seem to have been functioning very well the last couple of weeks, particularly this week. My personal hygiene is terrible - showering seems to have dropped to a once a week activity. I don't remember the last time I put any make up on, and I actually have to think quite hard to remember the last time I got dressed. It must have been Monday when I went to rehearsal, and of course I would have had to on Wednesday, but I didn't feel up to going. When I do have to leave the house it takes so much energy, and just feels so hard, that I can't even think about what I look like, and so I turn up to rehearsals looking a complete mess, in whatever clothes were at the top of the pile on my floor and with no make up on. I have to go to a rehearsal tomorrow afternoon and I am dreading it. I envisage it being a repeat of last Sunday, when I looked like shit (as my mother kindly pointed out, although not using that term), felt like shit, desperately wanted to go home, and was probably a nightmare to work with, as anything that anyone said just pissed me off. I tried to stay calm and professional, but inside I was feeling incredibly tense, and could just feel myself getting more and more irritated, and just wanted to collapse in the middle of the room and sob. Sometimes when I feel like this I just reach such a level of desperation that I just want to beg someone, anyone, random strangers in the street, to please help me somehow, to make it stop, to kill me, to make the pain go away, to help me find a way of having a break, anything. Of course I would never do it - I put on my happy face and pretend everything is fine, but inside I'm screaming.

Useless friend

I feel like a shit friend today. A friend of mine, who I met during Carousel, is moving to London next weekend as she has got a job there. I didn't really get to know her very well until probably the week before the show - that was a strange show to rehearse, as I was only in the long dance scene, and then two other scenes, so until a couple of weeks before the show the only other cast members I really had much to do with were the people playing my parents, as they were who my scenes were with, the dancers and children who were in the ballet scene, and some of the other principals because you tend to get to know them at initial read throughs etc. So I had spoken to her a few times, but that was about it I think. Then on the day of the tech rehearsal between the band call and tech rehearsal, five of us, including her, went out for lunch, and we got on well and during show week chatted a fair bit, and talked online, and then a week or two after the show finished she came over one day etc. I haven't seen her since then, which would have been early November, but we have continued to chat online. Anyway, because she is moving tonight she was having a farewell drinks thing. It wasn't a massive thing - she had invited quite a few people, both people from Carousel, and friends of hers that I didn't know, but I don't think that many people were going. She told me about it weeks ago, and although I felt a bit anxious, as plans were all a bit vague and I find that stressful, I had intended to go. But then this week has been so hideous that I just couldn't face it. And the pub people were meeting at is always packed, so she didn't even know if they would be able to get in there, or if they would have to find someone else, and I just cannot do busy places, and on a Friday night pretty much everywhere is going to be busy. I would have liked to see her, and the girl who played my mother in Carousel, who is a really wonderful person, whom I also haven't seen since November, was also going, and it would have been nice to see her, but I hate anywhere crowded, and although I would probably have tried to go had I been feeling better, there was just absolutely no way that it was going to happen this week. But I feel like a really shit friend for not going, because she told me about it so many weeks ago, and I just feel like she must hate me. I spoke to her online earlier and said that I was really sorry but that I wasn't going to be able to make it - she does know that I have mental health problems, although I don't talk about them in depth with her, and when I last spoke to her a few days ago I did say that I wasn't doing very well depression wise at the moment, and so when I spoke to her today I apologised and said that was why. She said it was fine but I still feel guilty.

Then something happened with another friend today that also made me feel really guilty and like a shit friend. I have a friend who I have talked about on here before a few times - the last time would have been when she came to stay in October, and she was also here in July. Anyway, I will henceforth call her E, as I realised I don't have a name for her. She has been severely anorexic for years now, and has spent a long time inpatient as a result of it, but was really very ill both times I saw her last year. She was on the waiting list for inpatient again, but comes from Ireland, where the system is very different, and there seem to be far too few ED beds for the number of patients, as there were something like 3 beds and 12 girls waiting for them. Anyway, when she was over in October she was talking a lot about wanting to get better, and hoping a bed would come up soon for her, but then soon after she went home she actually started doing much better. She was eating more, and managed to cut down a lot on the amount she was purging, and the number of laxatives she was taking, and was starting to gain weight. I was concerned that she would get to BMI 15.5/16ish and then hit a brick wall, as I know that is the point she has managed to get to several times in hospital, and has then relapsed, and I was worried because they took her off the IP waiting list as she was doing so well. Unfortunately it went more or less as I predicted - her BMI was high 15s before December, and she was really struggling with it and starting to cut back, and since then she has been finding it really hard, and has lost some weight again, although I don't know how much, and then the last couple of weeks has been feeling increasingly depressed. I spoke to her last night and was quite concerned, as she did seem low, although I didn't get the impression she was actively suicidal, although I may have been wrong, but she was certainly feeling bad and struggling a lot with her eating, and was back into her old patterns really. She was due to see her psychiatrist today, and she said she would be honest with them and tell them what was going on, and when I spoke to her this afternoon she had been admitted - not a long term ED admission, but a short term admission to try and lift her mood, and also stabilise her eating a little if possible. I had simultaneous thoughts - I was pleased that she was getting help, because I have felt for a long time like she needs it, although I don't think a short term admission like this is the answer, and I was glad she was safe, but at the same time I felt jealous. I feel terrible for saying that, because she needed help, and I am pleased she got it, but at the same time I don't understand why it often seems so simple for other people to access more help when they are struggling, and yet I never can. I am not saying I would want to be in hospital - it is always something I feel very ambivalent about, but when I spoke to her she said how it was a relief to have a break, and that just hit me really hard. I just felt like crying. Suicide is still my preferred option, but as at least a temporary alternative a break would be really bloody good right now. I am just too exhausted to keep going like this, and I feel like if I look at the short term I either need a break or I need to kill myself. Admittedly the local NHS psych ward wouldn't actually be my place of choice for a break even if it were an option, but I don't know. I guess I just feel so desperate, and this week has felt more horrific than I can even express, and so anything feels like it would be better than this. As I said, it isn't an option anyway, and if it were then I am sure I would refuse, as there have been multiple times in the past when I have been offered admission and turned it down - the only times I have been in hospital were voluntary admissions, but I wasn't actually given a choice about going. I just couldn't help feeling jealous knowing that E saw her psychiatrist today and was admitted, when it doesn't matter how much I struggle, or how desperate I am, I just seem to be left to do. But I feel really guilty, and like such an awful friend, not to mention really quite weird, for feeling jealous that E has been admitted to a psych ward. I suppose I just really am so desperate that even something I would usually avoid at all costs seems like a better alternative right now.

I spoke to L earlier. I rung and asked to speak to her, and they said she was with someone but they would get her to call me back. When three hours had passed and I still hadn't heard anything from her I was starting to give up, but she did call back. I didn't feel able to really say how bad things were - I tried, but at times like this it seems that the words don't even exist. "depressed" "suicidal" "desperate" "hopeless" - none of them actually even begin to convey how horrific it feels. It is slightly easier when I can ramble at length, rather than trying to form coherent sentences, but I don't believe the words exist to fully explain the extent of these feelings. I did try - I said it had been a really awful week and that I was feeling very depressed and was completely unable to distract myself, and that my sleep was awful and essentially that I just couldn't cope. She said more or less all she could I suppose - to try and plan my time and do things to distract myself, and to keep writing things down, and that we could talk about it on Tuesday. It just feels so futile. Talking about it on Tuesday won't make any difference whatsoever. I don't even want to be alive by Tuesday, although I probably will be I suppose. But it won't change anything. I am feeling really disillusioned with everything at the moment. I just see absolutely no way forward from here, and I don't view continuing to feel like this as an option, which once again leads me back to suicide. Even when I try not to think about it, it always pops up as being the solution. The right thing to do. The answer. Maybe it is. I don't think my brain would push it so hard, and so continuously, for so many years unless it was the right course of action. Brains are supposed to have survival instinct, but mine just tells me to kill myself.

This isn't living

I don't know what to say. I feel awful. My sleep last night was as bad as ever. I woke up to a text from the director of the show saying she wanted to rehearse Sunday afternoon again, which immediately filled me with dread. I hate feeling like this about the one thing I have always cared about more than anything. I perform because I love it, because I am passionate about it, because it is the only thing I have ever wanted to do. And yet I have the lead part in a brilliant show, and I actually dread going to rehearsals, and spend the entire time desperately wishing I could go home.

I feel like I have reached a point where I just can't keep going on like this. It is too hard, and I need a reason other than other people to get me through, and there just isn't one. I sometimes wish that I didn't care about other people's feelings as much as I do. I feel like it constantly means that I am left feeling like shit, and like my feelings don't matter, because I don't want to hurt people, or because people make comments about suicide being selfish etc. But how do you weigh up the pain of one person against the pain of another? The people saying suicide is selfish aren't the ones who have to live with these feelings of complete desperation every single day. I feel like to get through this I really need a lot more help than I have at the moment, but I also know that isn't going to happen. I also have severe doubts as to whether anything would actually help. I feel like I am past the point where having a little chat about how shit I feel will change anything, and certainly having a bath or going for a walk or any of the other patronising bollocks that mental health professionals are so fond of suggesting will not make a scrap of difference. Having said that, I did try to call L yesterday, as I mentioned, and I also sent her an email during the night last night asking if she could call me today, but she didn't. Maybe she wasn't in work, or maybe she didn't have time, or maybe she just didn't want to listen to me whine about how shitty I feel, which would be entirely understandable. As I said, I don't actually think it would help anyway - I just always feel an obligation to at least mention to a professional if I am feeling seriously suicidal, so that I feel like I have made an effort. Of course I know they will do nothing about it, but there is nothing I can do about that. I don't know. On the one hand I feel like I really need support to get through this, but short of locking me up nothing would stop me if I decided to do sosmething, therefore it is pointless to even attempt to get help, and on the other hand, I don't even know if I want to get through it. I feel like I have had enough. This has been going on for too long, and I have had enough of feeling this terrible all of the time. And now things are at a point where I just absolutely do not want to see anyone or go anywhere, and I would do virtually anything to get out of doing the only thing I have ever cared about. This isn't living. It may be surviving, but it isn't living, and what is the point of surviving when you have no quality of life?

Response

This is a reply to the comments I received on my post before last. I was writing it as a comment, but it got a bit long so I thought I may as well make it into a post.

Karita - essentially trusts will fund treatment out of area if they think it will be more cost efficient for them in the long run, so for example if someone frequently presents at A&E and has regular admissions to acute wards, and often has crisis team intervention, then they may well look into funding a therapeutic community, because it will probably not cost them any more in the short term, and in the long run should save them money. As Harriet said, these places do produce statistics showing that treatment with them is more cost efficient than frequent crisis intervention.

However, I am in the fortunate/unfortunate position (depending on how you look at it) of not having frequent crisis intervention, which is obviously a good thing in many ways, but unhelpful in this situation. I have the issue of not being your 'stereotypical' Borderline - I have been told this several times, and as a result I really don't cost the trust very much at all, and so there would be no reason for them to fund an expensive treatment programme for me. I have never been the type to self harm a lot, or take non suicidal overdoses and then present at A&E, so that isn't an issue for them. For reasons I discussed recently I am not referred to the crisis team - essentially L thinks they would do more harm than good, as they have a tendency to see everything other than psychotic illnesses and bipolar as being too insignificant to require their input, and therefore treat you like shit (I have experienced this), and they are also gatekeepers for acute wards. On paper the bosses of the trust, who make the decisions on matters like this, would see me as a stable patient, who copes with weekly or fortnightly appointments with her care coordinator, and doesn't require any other input, so they would be likely to see me as not needing intensive, expensive treatment. I don't even see a psychiatrist any longer, since she took me off my meds, so I am basically as straight forward as it comes in terms of the treatment I am receiving.

What I find very frustrating, is that if I acted on all the suicidal thoughts I have, then I would constantly be at A&E, I would be deemed higher risk and so would probably have acute admissions and crisis team intervention, and would be far more likely to be able to access appropriate treatment. However, because I am able to contain my behaviours generally to those not requiring medical intervention, ie superficial cuts, small overdoses that I don't seek treatment for as they are self harm rather than anything else etc, I look to be coping. But I have no standard of life, and I have been under services for 7 and a half years, and am as bad as I have ever been. This is something that came up in a session with L once, and she said something along the lines of me being equally as unwell as those with the same diagnosis who do fit the more traditional borderline pattern, but that obviously on paper it doesn't appear that way as I have become very good at containing it. But that doesn't help, as it leaves me with this nothing of a life, where I am unable to progress or do anything I planned, and yet because I don't 'act out' I will probably never be able to access the more appropriate types of treatment for me.

L actually agrees very strongly with the therapeutic community approach - she thinks it is very effective, and I know it is something she is very interested in, and would actually like to work in herself. However, it isn't her who has the power to make the decision, and there is no point in referring me if there is no chance of getting funding. My county is also particularly underfunded - I know they all are, but there really are no specialist services at all in the county - if children/adolescents need inpatient treatment they have to go to another county, same for eating disorder patients, there are no specialist personality disorder treatments, etc etc. They have the very basic services - the CMHTs, an outpatient ED service, and one EIPS team on the other side of the county, and that is more or less it. You can't even access the Crisis Team without a referral - there is no option of calling them when in crisis like you can in virtually every other area - you have to be referred first.

Pandora - I think at this point there would be very little point in getting my MP involved, largely for the reasons above - on paper everything looks fine, and I haven't been referred to any services but denied on grounds of cost, so I have no cause for complaint. Also, he is a typical Tory twat (who manages to vote in the opposite way to what I believe on every single bloody vote in parliament) who would probably consider me scum for scrounging off the state, and would probably think it better if I just killed myself rather than cost the government the sort of money that therapeutic community treatment costs!

I may be rather cynical over the whole thing, but I think that realistically a therapeutic community is never going to be an option for me unless I win the lottery, or some philanthropic millionaire comes along and wants to pay for my treatment! DBT and MBT aren't even options in the next trust, so even going out of area for those isn't an option. Essentially, nothing is an option, apart from what I have now, and I can't cope with that. I am somehow just expected to keep going, from week to week, or fortnight to fortnight, despite overwhelming suicidal thoughts, and feeling so terrible that I can't get out of bed most of the time. And this is one of the reasons why I see suicide as a valid and logical option - I have virtually exhausted my local mental health services (I say virtually, because I have not had CAT, which I believe is the only therapy other than CBT that is offered, but I don't realistically see 16 sessions of that changing things dramatically) and I have no other options treatment wise, I don't consider carrying on like this to be an option, and since nothing has changed for the good in the last 7 and a half years, I sincerely doubt it is suddenly going to happen now.