The Making Of A Mental Health Professional

I was thinking of all the common characteristics that make up a good mental health worker in my opinion and came up with the following list:

1. Real Life Experience - No book has ever been written that can truly cover what it is like to be at your absolute bottom, to fight for your own life, to understand the emotional turmoil that shows up when the people who are suppose to love you turn around and stab you in the back. There is good reasons why a high number of drug and alcohol counselors are recovered addicts.

2. The Ability To Empathize - Basically to have a heart. If you are unable to feel what the client is expressing then you have no business being in this field. I am not a book or a diagnosis but a person who would love to be cured but even more important I need you to understand where I am coming from and what I am feeling.

3. The Ability To Think Outside Of The Box - Not everyone with depression or any other disorder is going to respond to the same treatment. This field is not like an office where every time problem A shows up the person uses solution A to fix it. The worker needs to see the situation from every possible angle to come up with the best course of action. The DSM is a book of guidelines regarding a diagnosis not a set of instructions.

4. Nonjudgmental - During on of the first classes I took in college the teacher asked who in the room would not treat sex offenders and child molesters. When a couple of people raised their hands the professor responded "Then you should not be in this field for every single person who has a mental or behavioral problem deserves to be treated and seen as a fellow human being who deserves help". The ability to see the person behind the illness is essential for if all you see is the problem then nothing will be accomplished.

5. Consistent - A major problem with mental illness is it tends to be chaotic with everything in the persons life in a constant state of change. The worker needs to be a rock instead of another piece in the clients life that is unpredictable.

Well I believe that the above criteria are essential to anyone in the mental health field. Any others? Take care.

Mental Health Journey

With my blog being featured over at The Experience Project I think this is a good time to reintroduce myself. Many of the major areas of my life have been detailed to a certain degree throughout the brief history of this blog but I will use this post as a way to summarize my journey so far.

I have been dealing with depression for as long as I can remember. My family history has mental illness on both sides going back for generations. Chances are I was depressed the day I came out of the womb and have been unable to get rid of this silent monster since.

Self harm started when I was seven or eight with the intention of punishing myself so I would be a "good" child and maybe people in my life would finally leave me alone. Needless to say this did not work. When I was twelve or so I tried to end my life and somewhere in the process I realized that as the blood left my body a sort of cleansing occurred which seemed to make me feel better. What I did not realize is this new monster would stick around for the next two decades.

To be honest I have no idea why I am still alive and there are pieces of my past that are a complete blur. Sometime in my mid twenties I seemed to have found the ambition to get my life back on track. I enrolled in college in Social Service Worker program with the intent of not only figuring out my own mind but also to be in a position to help those in need. The material of the course came very easy to me and I seemed to be flying through the program. In the last semester of college my father passed away and I did what I have always done which is completely ignore the emotional turmoil by throwing myself into another aspect of my life.

I graduated from college in May near the top of the class, in June I started to work at a group home for troubled teens and in July I married my long term girlfriend. For a while I thought my life was finally on track and everything seemed to be perfect. About a year and a half after we were married we were blessed with a beautiful baby boy.

Then things started to go wrong. I was constantly sick and had a lot of problems getting to sleep at night then when I did get to sleep the nightmares made Freddy Kruger look like Big Bird. When my son was about a year and a half I booked an appointment with my family doctor for at this point I knew I was in trouble and was very quickly losing control over all aspects of my life. After a brief meeting with the doctor I admitted that on the way there I was tempted to pull in front of every eighteen wheeler that passed on the opposite side of the road and the suicidal ideations were becoming a normal part of my life. The doctor immediately pulled me off of work, prescribed an antidepressant and made a referral to a mental health doctor. I honestly thought at this point that the med would kick in and I would be back to work in a matter of months but that was not the case.

I met with the mental health doctor a couple of months later and was diagnosed with severe Major Depression Disorder with psychotic features. He switched my medication and so began the experimentation of mental drugs that I have been on over the last few years. A couple of months later Paxil was tried and it effected me in a negative and dangerous way. Within a week of being on this med my self harm behavior went through the roof and it was impossible to tell which mood state I would be in from one moment to the next. With my wife basically threatening to leave if I did not enter a hospital setting plus the push from the doctor I agreed to be admitted into the hospital.

For the next two months I went through talk therapy numerous times per week, a variety of medication was tried and I went through five sessions of ECT. ECT is Electro Convulsive Therapy or what use to be known as shock therapy. After the fifth session it was stopped as I was taking a very long time for me to regain consciousness plus there did not appear to be any real positive changes. At the end of the two months I convinced a floater doctor that I was perfectly healthy and he signed my release papers which pissed off both my doctor and my wife.

A few months after the hospitalization all of the negative behavior had reappeared and the medication that I left the hospital on was beginning to lose its effectiveness. My wife took our child and left as my behavior was to unpredictable. My now ex wife did not make this decision hastily and in a lot of ways I basically pushed her out the door (thats another post).

I went through a number of mental health "professionals" in this period with the first one being arranged by the therapist in the hospital. This is going to sound terrible but it is the way it was and is, I admitted in the third appointment that during a rough period I resorted to self harm to get through the situation. Once I told the therapist this she basically ended the session as she felt I was not stable enough to treat. The next few therapists would reach the same conclusion and stopped treating me.

Fast forward a couple of years and another bad self harm session that through the doctors eyes looked like I tried to take my life again. So back on the psych ward I went but this time it was located in the city's main hospital that did not have a full time therapist on duty because of budget cuts and it makes too much sense. Some time during this admission I decided to tell my mental health doctor absolutely everything that I have been though during the course of my life. The first version was basically just the facts with little to no detail and due to his positive reaction stating he learned more about me in those few pages then he had in the two and a half years prior. I wrote out the second edition which gave details to the facts but still not disclosing everything. Again the doctor encouraged me to keep writing so I started the final version. This last version was pretty intense to say the least and an example would be I talked about my grandfather which is one of the best relationships in my life and a couple of pages took hours to write for every single detail I tried to include in the section. Each day I would submit a new section to my doctor who would read it carefully then gave his take on it. When I finally finished this last book on my life he advised me to give it to every mental health professional that was trying to help me so they would be able to treat me more effectively.

So I figured that no one knew my brain like I do I decided to create a treatment plan that would lead to recovery. I wrote out all of my issues and what would be the best way of treating them. I handed the paper over to my doctor who completely agreed about my plan but then stated that this city's mental health system would be unable to provide the specialized help that I needed. Another part of the treatment plan was to list out the diagnosis that I felt fit me and to this day I wonder if this was a mistake for everything was about to change.

The diagnosis that I listed were Severe Major Depressive Disorder with Psychotic features which had already been diagnosed a couple of years earlier. Post Traumatic Stress Disorder which was rather obvious if you look at the amount of abuse I have been through plus the flashbacks and nightmares. Generalized Anxiety disorder which tends to go with PTSD. The last diagnosis I listed was Borderline Personality Disorder and the second my doctor saw it his face lit up like a light bulb and declared it a perfect fit.

Due to the hospital not being able to provide the type of treatment that I needed I decided I would be better off back at home and seeking more specialized help in the community which my doctor agreed to. After a month of trying to contact every therapist around plus using a variety of mental health agencies for assistance I returned to my doctors office very frustrated. I told him about my problems finding help and he replied "Your too Borderline for treatment to be effective". Over the next couple of months he would add "Your going to have good periods, then your going to have bad periods which will cause you to crash and a hospitalization will be needed to stabilize you and then the cycle will repeat". Basically the goal is not to "cure my problems" but to avoid the hospital as long as possible. In my doctors eyes I am untreatable.

Do I believe the "untreatable" label? It really depends on the day. Over the last six months I have worked through various aspects of my life and I do see a light at the end of the tunnel but at the same time there are times when all of the movement I make seems to be backwards.

This blog was created so I would have a place to empty out my brain instead of trying to swallow the emotions/turmoil, a place where I can write everything down so I could analyze and try to correct any faulty thinking patterns. This blog is my therapy and for whatever the reason a lot of people seem to relate to it so at the very least I know the last three years has not been a complete failure.

Sorry for all the jumping around and like I mentioned earlier most of the above has been broken down in other posts that I have written. Any comments or questions do not hesitate to ask and I wish you all the best in your own journey. Take care

Trust

I have a massive issue when it comes to trust which is a major hurdle that I need to overcome if I ever want a clear shot at recovery. The mere thought of putting my well being into the hands of others sends shivers down my spine. This is something that did not appear when my breakdown occurred but probably started sometime in early childhood and is a main factor in the development of what later became Borderline Personality Disorder.

Right off the bat the first people you are suppose to trust is your parents as they are responsible for damn near everything right off the bat but when certain circumstances happen this is put into jeopardy creating a sort of movement that is going to take a long time to get past. I could never figure out why the people who were suppose to love me and keep me safe would repeatedly put me into situations that caused me harm. My father who could go from fun loving dad to pissed off at the world in a heartbeat created an enviroment that was a long way from being safe for a child. I never knew what mood he was going to be in so it kept my anxiety level sky high and helped mold my BPD false self in order to eliminate as many factors as possible that would set him off. You can not trust someone you fear.

Both of my parents like many around the world worked full time so my primary care giver was someone outside of the home. It was my parents responsibility to make sure that all of the proper steps were taken in order to ensure my safety and well being needless to say this did not happen. I went through a number of different sitters and I would imagine some were wonderful people but the others should have picked a different occupation. Again my view of trust was distorted for how can I trust someone who is suppose to ensure my wellbeing but continues to cause harm on a way to regular basis. Too many days were spent wondering if I was going to get my ass beat at home or at the sitters or both.

Depending on the year teachers were the closest thing I had to a responsible adult in my life but like everything else there were exceptions to the rule. Finally gathered the nerve to tell the teacher about the abuse I was taking outside of school to only be told if I was a better behaved child it would never happen. Basically the same situation repeated a year later and I learned a lesson that I would hang on to for years to come "The only person who I can trust with my wellbeing and safety is me for no one else cares what happens".

Doctors are a difficult group of people to trust as a whole. The first appointment they basically promise the world in terms of recovery then over the next period of time repeatedly fail to come through. I would imagine part of this is my expectations are off base but it seems every time I try to combat these negative thoughts with logic the only thing that comes to mind is examples from the past which are far from positive..

Therapists and I do not have the best relationships. In a therapy setting you need to be completely open in order for the best possible result but I have found out the hard way that there is something known as too much information. After my first psych stay I was set up with a therapist who has a wonderful reputation of helping those with historical abuse issues. Everything was going well for the first couple of visits until I made a mistake in the third. She asked the typical question on any progress or setbacks since the last appointment and I admitted that I hit a rough patch where I turned to self harm. Almost instantaneously this therapist decided that I was not in a stable enough place mentally to go through therapy and that was the last time I ever saw her. She was followed by two more therapists who basically came to the same conclusion after my self harm issues came out into the open. Since then I have tried to contact a dozen more therapists but once I mention that I do have the Borderline Personality Disorder all communication is cut off and this is before any of them actually took the time to meet me in person to judge for themselves how well I may respond to treatment. I have come to the conclusion in order for me to obtain treatment in a therapeutic setting in this community I am going to have to fail to mention that I am BPD and I have a lengthy self harm history. Not sure how I am going to be able to be open with someone when I believe I need to lie from the onset in order to get proper care.

Nurses. Well if you have read yesterdays post you will have a fair idea of where the relationship stands with that specific group of people. This area tends to be more separated then others as I try to figure out pretty quickly early on which are in it for the money and which are in there to help. My communication with the two groups is totally different and it has to do with trust. Very difficult to trust someone that does not look at you as a person but what is written down in a file and on paper I past the crazy line a long time ago plus that damn word untreatable is probably in capital letters.

I do try to give everyone I meet a chance to show me what kind of person they are in and more then once my original assumption was proven wrong. The problem is when the little warning flags start to appear and with the way my brain works situations from the past are quickly linked which ends up putting up the walls to keep me safe. Like I said earlier this is an area I am going to have to figure out how to get around but I am basically clueless on how to do so. Take care.

Sorting Out The Mess

Just came back from my monthly appointment with the mental doc. As mentioned earlier and rather obvious from the post earlier today it tends to get under my skin. This time he had a medical student with him so I knew right off the bat that he was wearing the good doctor face where he at least had to appear somewhat concerned of my well being. Alright on with the highlights:

- Little discussion about therapy and he actually admitted that some therapists do not feel comfortable treating Borderline clients. I said that every therapist I have encountered or have asked for help in this city of ours meets that criteria. I then said when people entered this field it is to help those in need and not to pick and choose who is worthy of treatment. The doctor again tried to bring up the difficulty of BPD clients which I responded that yes I would take some time to treat but if a therapist is going to determine who they treat by the difficulty of the case they need to find a different line of work. He was not too trilled by this comment and immediately switched the topic.

- The doc asked if I was cutting and I said no then later on he asked if I was burning and I responded with a dirty look and then he asked later on how often I was cutting and he received another dirty look. Normally he never asks so it is a little bit weird him asking repeatedly and especially about different methods but I have a feeling this was more for the students benefits.

- The doc then said that I use to counsel people before and because of this I am basically an expert on Borderline Personality Disorder. Now I have no idea where this is coming from and I can not remember having a child in my care with the BPD diagnosis nor do I remember ever taking it in school. Weird statement that I chose to ignore.

- Then treatment or the lack of it became a topic of conversation. I said they only thing that has happened in the last three years is different experimentation of meds and the first response to every crisis has been to increase the dosage. Therapy or the lack of it was brought back out into the open to which I replied I had three therapists who stopped seeing me once I made the mistake of admitting to a self harm problem which in their eyes made me seem unstable for therapy. I brought up that someone I know who is a patient of his is seeing someone who uses DBT as part of the treatment which he completely played dumb on (or maybe he was not playing). He said a number of people who work in the hospital (his office is in a mental hospital) have taken the training for DBT but he does not know of anyone who actually uses it. Have an odd feeling he thinks I am making up this therapist with DBT training so I need to get the name by the next meeting.

- Suicidal ideation came up like it always does and I like usual admit to constant thoughts about suicide which then is followed by asking if I had any specific plans which I do not. Like always I replied my child is the reason that keeps me on this side of the playing field and then he asked if I decided if it was time to go would I take my child with me. Now he has never asked this before and I quickly denied this as being an even remote possibility but of all the questions asked today this one is going to stick with me for awhile. Everything that I do in terms of recovery is to get to a better place in order to be the best parent possible and this has been my focus since day one. I understand why he did ask but this question caught me completely off guard.

Anyway that was the majority of the appointment and I do apologize for the whirlwind matter in which I tried to express it but at the moment it is difficult to tell which way is up. Oh the doctors amazing treatment suggestion was the same as always I need to get out of the house more and once all of my dental work is finally complete "we" are going to retry Nardil or another MAOI antidepressant. Thanks doc see you in a month. Take care.

Unloading

Had an appointment yesterday with another mental health professional which meant another intake interview. I don't know how many of these types of assessments I have done but the number is becoming rather high and they always seem to leave me drained. my brain is not cooperating today and it is difficult to stay on one track so chances are this post is going to be all over the place.

1. She asked about suicide attempts and suicidal ideation. I told her about the two documented cases which led to hospitalizations and basically said they were results of a cutting session that went way too far. The thoughts I admitted to having on a daily basis but tried to justify by saying this is just part of depression. The second the statement left my mouth I realized how ridiculous it sounded but I could not think of a better answer. The worker asked if I was suicidal which I replied no which is the truth but I know where a positive answer leads to so I will never admit to it no matter who I am talking too.

2. We were talking about work and I received the typical reaction when the mental health professional realized at one time I was one of them. I explained that I loved what I did and the goal is to get back to working with teens but at the moment mentally I am rather unstable so I was not able to stay focused on one area for any lengthy amount of time. I want to return to work and I toy with the idea on a regular basis but how can I tell someone else how to live when my own life is in shambles.

3. Turns out I really hate my doctor and don't think much of the rest of the mental health system in this town. I admitted to going into my doctors office with the intent of getting out of there as quick as possible and every time I attempted to reach out it was a waste of effort. All my doctor does is increase my medication in the hopes that I will shut up and every time I suggest a different approach it is shot down immediately by a statement that holds no water. How much of this response is accurate and how much is the result of a misguided perception? Like everything else in my life it depends on the day if not the moment.

4. The lady, who was very nice and supportive by the way, asked if I had any solutions to my situation which is a great question that I have been very rarely asked by other mental health professionals. I believe that the key to my recovery is going back to the beginning of my life and working through what took place over the next twenty years or so. If I can somehow figure out and put to rest the events that took place the PTSD diagnosis would basically disappear (hopefully), the Borderline Personality would calm right down as I would actually believe that the reasons behind its creation are no longer in play and the depression would no longer be enhanced by the negative BPD perspective which would in turn give me the power back over my life. Same plan I have had since day one whether or not it would be successful I have no idea but it has to be more effective then what I am doing now.

5. The worker at the end made a statement that I needed someone just to unload on so I would not have to carry it around in my head. This person would just listen to what I was saying and I would not have to worry about being judged or changing the way I am perceived. When I started this blog that was one of the main purposes just a place to let everything out but something along the way changed. Everything on this blog is 100% accurate and truthful but at the same time I am only showing a certain section of my life. Part of this is the fear if I let everything out I would have to admit that I am not winning this war on mental illness and its not even close a statement that I deny daily just so I can keep trying to move forward.

This worker is going to help me find a new place to live in the near future and has also opened up a variety of options in terms of mental health treatment and for that I am very grateful. Unfortunately there has been a number of other mental health "professionals" who have promised to help but then ran away once they saw the whole scope of my illness but hopefully this time it is different. Take care.

If He Walks Like A Duck...

Back when I was in school studying social work the professor who taught the introduction to interviewing told the class not to watch Dr. Phil as he was a bad example of the proper way to counsel others. For the most part I listened to her and tend to avoid his program like the plague.

A few months back in the middle of the Britney Spears fiasco Dr. Phil jumped up and tried to elbow his way into the picture. His actions during that period had nothing to do with wanting the best care for Ms. Spears but to gain publicity and I personally thought he hit a new low.

Well turns out there is a couple stages lower as in the last couple of days that are almost difficult to comprehend. Six teenage girls attacked and beat another girl badly with the intention of posting the video on youtube in some sick form of becoming famous (link to article). The six girls were arrested and a couple of days later Dr. Phil once again crossed that boundary by placing himself in the middle of this terrible event. Now if his goal was to help the victim overcome the severe trauma that she has dealt with I would more then likely be keeping my mouth shut but that is not the case. Instead one of his staff members posted the bail for the alleged mastermind behind this event which you can read about here.

There are different rules and regulations regarding the professionalism of doctors so I can not say which ones Dr. Phil scuffed up but I would have to think there is more then one. I guess all that matters is the balance in the bank and the hell with the ethics.

The Reasons Why I Am Untreatableonline

I was over at The Hopeful Borderline who has come back after a brief absence and she was talking about reasons why it is important for people with mental illnesses to speak out but at the same time realize the fall out that may come from running a blog. At one time I started another blog using my real name and it didn't work for a number of reasons so here is why I chose to try again under the name untreatableonline.

1. When I was using my real name I had to take into consideration how the stories I told would effect other family members and it really hampered the information that I tried to share. As untreableonline that is not a concern so I am able to tell the whole truth and nothing but the truth without a worry how others would see my family as the reader does not know who they are. Strangely I really do not care if people like me or not but I do care how others treat my family especially when it comes to something that I did or said.

2. Mental Health Professionals - I am not the easiest client on the block and to be quite honest I have no idea if the way my doctor or a past therapists treated me is normal to the way they handle other clients. The last thing I want is someone to walk into my doctors office and think well Doctor X treated untreatable this way so I need to watch out for whatever as by doing so the reader is basically shooting them self in the foot. The other concern is one day I hope to find a therapist who is willing to take me on as a client and I want them to see me and not untreatableonline as there is a lot more to me then what I write about here. Therapy is difficult enough and if my diagnosis don't scare them away the potential of seeing their name attached to this blog will. As for the professionals who have already dealt with me it will not take much effort to match me to this blog but I have to hope they will see what I am trying to accomplish here and not as a personal attack against them.

3. Who I am is really not important. I did not start this blog in the hope that it would lead to better care for me but better care for everyone who is in a similar position. I get a lot of comments about my courage and strength for speaking out which my brain really does not handle well (it is a BPD thing)as I see it like this: I am in a bad position so I can sit here and mope or I can speak out which provides me with a form of self therapy and there is also the chance it may help someone else.

For the readers out there who have been debating whether or not to start their own blog regarding mental illness I would say go for it but really consider the fallout when it comes to using your real name. There is a sort of freedom knowing that a lot of people know your story but none of them would be able to pick you out of a crowd in the "real" world. The goal is to lift the veil off of mental health but not to become the poster boy in the process.

Self Harm Awareness Day Continued

The first time I left the hospital the therapist set me up with a lady who specializes in PTSD and long term depression cases. Everything was going fine til the third meeting when I made a mistake by being honest. The new therapist asked how I had been since our last meeting and I replied that I had a very bad night which ended up with me taking a razor to my inner forearm causing a good amount of damage. This lady who specialized in difficult cases asked to see my arm and I complied then she said something I will never forget "You are too unstable to treat". The odd thing is for the longest time when I was cutting my mental stability was pretty solid as this negative coping mechanism was a way to allow my inner turmoil out before it lead to me blowing up at someone or ending my life to escape the pain. Not a great way to fight for your life but at least I was fighting.

The one comment about self harm that has always stuck with me and I wish I could remember when I first heard it first goes like this "If you think the scars on the outside are bad you don't want to see the scars on the inside". Self harm is about pain, pain so intense that you are willing to make yourself hurt to make the pain go away. I am talking about emotional pain on a level where I debated with myself about taking a hammer to my hand so my focus could be on the physical and not the emotional. A line from the movie Girl Interrupted sums this up well "to hurt yourself on the outside to kill the thing on the inside"

The stats are all over the place when it comes to self harm/self injury and it is difficult to be pin point accurate as a large percentage of people who self harm will never be seen by a doctor for that reason. The people who do come forward either accidentally went to far or there in the middle of a mental health crisis. Most statistics point at females being the majority of self harmer's which I believe is accurate but not as wide of a difference as most research points. A female is a lot more likely to go to her doctor then a male as it is with a number of mental disorders just do to society standards alone but that is slowly changing.

Hopefully with more awareness of this issue then more people will come forward with their problems relating to self harm and the medical/therapeutic community will have the knowledge to treat instead of the reaction that happens way too often now. Self harm is not a cry for help but it is a scream that needs to be heard.

Do You Really Need Those Meds

A comment showed up today outlining a situation where a million and one different meds were tried all to no avail but the person was able to get to a better position in life simply by a lot of hard work. This relates back to a very old argument that is not likely to slow down any time soon which is nature versus nurture or were you born with a mental health disorder or did someone teach it to you.

Depression is a disorder that is hotly debated whether it is a cause of a chemical imbalance or it is a condition that was created by poor decision making, emotional control and circumstance. If it is a chemical balance the best course of action is medication that will settle the brain chemicals but if it is the latter theory then the best response is therapy. What do I think? When I am on the right med my illness is tamer but it does not go anywhere and only through a lot of hard work and therapy will my depression ever be in check. I see anti depressants as a tool but not a cure. The meds calm down all of the distracting elements of the disorder so I can focus on the main problem which in my case is a faulty thinking process and a pass that will not go away. Anti depressants equal huge profits for drug manufactures who lean towards the chemical imbalance because that is where the money is. We live in a society where everyone wants action now and unfortunately too many people believe that an antidepressant is the solution when chances are all they needed was time and to create an ass groove on a therapists couch.

Borderline Personality Disorder is a Personality Disorder but right now there is a movement to get it classified as a mood disorder. For the longest time people believed that BPD was taught and a result of circumstances but lately there is this movement pushing for a brain defect. A personality disorder can not be treated easily with medication for there is nothing wrong with the chemical makeup of the brain. Again the best course of action is therapy to unlearn the negative thought process's which lead to the disorder but if it is a brain defect then it opens the door to medication which leads to profit for the fat cats at the drug manufacture head office. DBT or Dialectical Behavioral Therapy has shown tons of success for people with BPD so it kind of makes you wonder who is responsible for all of the "new" research and studies that keeps coming out, yes I am being sarcastic.

When it comes to a disorder that is routed in nurture the best cure is hard work and therapy with meds coming into play for a small percentage of people to provide a small role in cleaning out the mind so it is easier for the person to focus. When the disorder starts way before parenting begins then meds do play a key role as all of the therapy in the world is not going to fix a brain glitch or a chemical imbalance. The problem right now is too many people are asking their doctor for some chemical help when the person should be asking for a referral to a therapist.

Mental Illness To Do List

All of a sudden the winds of change come roaring in from the north and leaves you suffering from a mental illness. This may very well be the most difficult stage in your life but there are things that you can do to speed up the process and get you back into the ballgame called normality.

1. Hate to break it to you but your doctor, nurses, therapists and counselors are human beings who do make mistakes. If you do not agree with what your mental health professional is saying then question it immediately. Last time I was in the hospital a nurse came by to take my blood. I asked what the test was for and she gave me an odd look then checked the form. The test she said is to test my lithium level and I responded nicely I had stopped taking lithium a couple of weeks earlier. She checked and sure enough I was no longer on Lithium so no poking needles for me.

2. Write everything that you want accomplished in a doctor's appointment beforehand. The problem with some mental illness is difficulties with focus. The doctor says something that sends you in the wrong direction and before you know it all of your questions that you wanted answered never happened. Write your questions and concerns down and just hand the paper right to the professional at the start of the meeting.

3. Keep a daily journal where you include all emotions and behaviors through out the day. This serves two purposes (A) It provides the doctor with the information that will help them serve you better (B) It may show you and the professional the patterns that you seem to be following and the faster they are identified the easier they are to correct. This is a very helpful tool when figuring out meds, med dosages and self injury trends. When I started Seroquel everyday I would have problems in the earlier afternoon. The doctor took the action of adding an additional dose and the difficult period disappeared. A trend I have experienced is when you tell the doctor of a bad period they are slow to react but when they see it written down on paper the doctor quickly responds. Go figure.

4. Tell your doctor, therapist or whoever everything. Something that may seem small and insignificant to you may be a indicator of a major problem. Your mental health professional relies on you for the information to help solve the issue and if you do not tell them everything your basically shooting yourself in the foot

5. Medication. There is a very good reason why your doctor has you on medication and I know the side effects suck but it is important to stay on them and make sure you take the meds every single day. When you decide not to take your med one day and then starting again the day after your putting your brain almost into a shock like enviroment which causes more problems. For the majority of mental meds to be effective they need to hit a certain level and stay there. If the side effects are just to much to handle then call your doctor immediately but do not stop the meds on your own or you may be introduced to a new level of hell.

6. The stronger your support system is the better off you are. The best part of the internet age is that it is easy to find support. Find a forum that you like, join an online group, invite your friends and family to join the fight just do what you have to do to get as much support as possible. Unfortunately all of your "friends" may be on board at the beginning but a lot of them will disappear with time. Online forums and groups are full of people with the same condition, emotions and behaviors who can identify with your battles and are quick to offer a pep talk, advice or an ear to listen.

7. It is up to you. The best care in the world will mean absolutely nothing if your not willing to fight for yourself. Sitting around waiting for the sickness to disappear may work with the flu but it does not work with mental illness. If you do nothing then nothing will happen except for your condition getting a lot worse. Fight for your life and fight for your recovery.

8. Routine. It is important to establish a routine and follow through with it. With depression it is easy to let little things slide such as eating, hygiene and leaving the house. Every day I make sure I eat, shower and leave the house at least once and to be honest more then once I had to force myself to do so but I recognize how easy it is to fall into a trend that will just cause more difficulty.

9. Recognize when your in trouble and act. There may be times when your brain just decides to jump out of your head and go south. This is the time when you tell your doctor that it is time for a more intensive form of treatment. The saying I use that involves this area is "When I can not convince myself I am not a danger to myself or anyone else it is time to check myself in". The life you are saving may very well be your own.

10. Hope. Never give up on hope that things will get better. If you believe that you will never get better then that is exactly what will happen. Remember it does not matter how you fight just that you are fighting. Never give up on yourself.

Well there is my top ten to helping yourself on the way to recovery. Believe in yourself and the possibility of a better tomorrow then you are already on the path to wellness but whatever you do don't give up.

Helping Someone Who Self Harms

I spent a good portion of today using stumbleupon to view the various self harm/self injury/self inflicted violence sites that are out there and I was left shaking my head. The advice given to use when someone in your life that uses this negative coping behavior was almost scary so I figured it was time to make a list of my own in what helps and what doesn't.

1. Using Guilt To Get The Person To Stop - This really really does not work. What it does is sends a message to the individual who is self harming to be more careful in not getting caught the next time. I have seen too many young people who participate on forums saying "I tried to talk to my parents but all they do is make me feel guilty which makes me want to cut more".

2. Saying "Scars last forever" - This might work on someone who has cut once or twice but it loses all of its power after that. Once you past a certain number another scar really does not matter. Personally the use of self harm in my life was done so I will not explode and don't end up taking my own life. Don't really care what I look like in the casket but I am trying to delay it for as long as possible.

3. Ignoring The Marks - Whether it was completely by accident or the person wanted you to see the mark take the opportunity to discuss it with the person. Keep in mind though that the focus should not be on the mark but what led to the action that created the mark.

4. Using Religion - Seen way too many forums where people ask for help and in return a person responds using a quotation from some form of religious writing. Another guilt trip using someone else's words is still a guilt trip that will not work.

5. Not Taking It Seriously - A past post dealt with this which is located here. Whether or not the person is self harming for attention, release or suicidal intent you really do not want to take a chance. A mentally healthy person does not "cure" themselves by inflicting damage on their own body and chances are a major mental health problem is at play. Encourage the person to see a mental health professional or grab them by the ear and drag them to the local emergency room. A self harm accident usually reads suicide on the autopsy report.

6. Help The Person Create A Safety Plan - A main part of this plan should be that you will be there for the person when an urge arises and here is the important aspect you actually need to be there. When I first became sick all of my friends said anytime I needed them they were just a phone call away then apparently changed their phone numbers within a couple of months.

7. Therapy And More Therapy - Long term readers of this blog are now scratching their heads due to my relationships with therapists but when it comes to self harm therapy is very important if the goal is to stop long term. Most people who self harm A) Do not know how to express their emotions in a healthy format so they end up swallowing their pain and then use self harm to release these emotions. The purpose of therapy is to teach the basic skills needed to handle emotions in a healthy way. B) The person does not have a person in their lives who they feel safe or comfortable to really talk too as they are concerned about their image, they do not feel that the people in their life are actually listening to them and they do not want to burden someone else with their problems. A therapist can solve all of these issues by being a safe point for the person to unload on with no fear of judgment or consequence.

8. Relapses Will Happen - Just like in any other form of addiction relapses are almost normal when it comes to recovery. When a relapse happens just brush the person off and encourage them to jump back on the horse. A relapse is not a failure just another hurdle to get over. I met one lady who said she went three months then relapsed then five months then relapsed and all she could focus on was the relapses when from a different perspective she has had a eight month recovery process with two minor relapses. Focus on the positive not the negative.

9. Blaming Self Harm Behavior On Their Friends - I keep seeing too many people push self harm to the side with a comment like "Oh she/he is just trying to fit it" or "It is part of the teen subculture Emo". Think about that for one second. Your young person is so easily influenced by friends or a cultural movement to purposely inflict damage on their bodies. A therapist might say there is self esteem issues at play and so would I and again self injury can be an indicator for a much larger problem that needs to be attended too.

10. The Earlier It Is Caught The Easier It Is Stopped - Self injury tends to start with a major crisis in the persons life but it very quickly becomes the preferred method to any sort of problem large or small. Some people come home from work an grab a drink to unwind I use to grab a razor for the same reason. Catch the problem when it is small and the chances of recovery are significantly higher.

The reason I never use the term "Self Mutilation" for that brings up an image of a drunk teenager writing their girlfriends name on their body with a razor then dumping ink over it to create a home style tattoo. As for your other questions I have been cutting off and on for two decades, it has been around four months since the last time and I have too many scars to count.

When Money Comes First

Throughout this blog I seem to be going after specific worker areas in the mental health care system and I do this for a reason and that is I believe this is where the most changes can take place with the most ease. The much larger problem to the mental health system in this country, Canada, and other countries around the world is the infrastructure is controlled by people in the government who are barely qualified to be in office let alone making decisions that effect millions.

Budget cuts have put the mental health system in a noose and sooner or later something is going to happen that will knock the chair loose. When I was working I dealt with Children's Aid Society(CAS) workers on a very regular basis as they basically controlled a lot of factors of the boys that I would work with. This system has been in place for a very long time but over the years the case load of each worker continues to grow year after year. At one point the workers had somewhere around thirty cases each to look after but now the number is fast approaching a hundred. So what happens is the children who deserve extra attention by their workers and should be making the next step whether into foster care or back home are being put on the back burner by other boys who spend way too much time in court and in trouble. This is not a conscious choice by the workers but when a good percentage of your time is spent in mandatory meetings, court hearings and the occasional treatment plan development it just does not leave you with the time to get to your entire caseload. Most of my boys relationship with their workers was done by fax machine which is wrong on all sorts of level but that is the way the budget cuts has led it too. Take a wild guess on how high the burnout rate is in this specific area. The CAS workers all started with the best intentions and that is to help children in trouble the problem is reality and budget cutbacks make their job extremely difficult and unfortunately too many young people go from John Doe to case number 9494, the caregiver part of a CAS worker has slowly been ripped away.

The first time I was in the hospital back in 05 I saw a therapist three times a week and she is a big reason why I decided to join my own fight again. This amazing lady set me up with a PTSD specialist in the community as she could only sees clients who are currently in the hospital. Anyway I lasted three meetings with the new therapist when I made the mistake of telling her I had a really bad night so I took it out on my body, according to her I was not stable enough to be in therapy. So when it was time to reenter the hospital I was sent to a local psych ward where I was a little bit shocked to find out that they did not have a on staff therapist as the budget would not allow it, yes thats right a psych ward that could not afford a therapist. What the hospital did was send a grief counselor down to see me I think three times during the month that I was there and this lady was good at what she did but just did not have the time to be effective. I saw my doctor every weekday for about five minutes at a time but his specialty is medication and diagnosing and not talk therapy which he has stated repeatedly over the years. The psych ward did have groups which are good for some people for small areas but nowhere near the impact of a one on one session brings. To me the system of emergency psychiatric care is designed to bring the person out of a crisis, medicate heavily then send back out the door and basically wait for the person to come back some time in the future. Medication enhances therapy and makes it possible for the person to really get at their problems but if there is no therapist around to help do the work the job is left to nurses whose technique comes from experience and not actual education. Someone told me that to work on the psych floor they need to take a two week course about dealing with mental health clients and I use to wonder why so many of my fellow patients would bring their issues to me. Maybe this is why I was always kept longer then the others as I was free help .... not likely.

I watched a documentary awhile ago about the new asylums in the states that appeared after a high number of state hospitals were closed due to budget cuts, mind you the new asylum is actually an older prison. I wonder where the politicians though that these people that populated the old state hospitals would go when trouble appeared or did they think the problems would just disappear but more then likely they did not care and just wanted to put through a sensible budget and the hell will the human consequences.

The only thing that will fix this area is money and lots of it but I am not going to hold my breath waiting for that to happen.

Tomorrow You Could Be Me

When I started this blog a month or so ago the plan was to try and give a voice to a section of the population that tends to go unheard. Too many times when the world media talk about mental health it is about a tragedy either at large national level such as a mass shooting or a personal level such as poor Britney Spears. So I made the decision to share with whoever happens to land on this blog what my world is like with mental health quirks.

The response has been almost overwhelming at times. Emails from people who are fighting for their own survival yet still capable of offering a complete stranger support. Emails from people thanking me for explaining parts of various illnesses in a way that they never fully grasped before. Emails from people thanking me for having the strength and the courage to put my soul on display so it could help others who have been left without a voice. This last category is what I am going to direct today's post.

I have kept my identity some what of a secret but chances are anyone who has dealt with me well make the link pretty quick which is fine and if I was really honest with myself to be expected. I am waiting for the day when my doctor or some else in the medical or therapeutic community asks if I am untreatableonline. "Yes I am" I will declare then try to deal with the reaction they give me. I would like to think it will be positive and they can see the purpose behind this blog but I imagine there are going to be people who believe what happens in the mental health world should stay there. Part of me wonders if this is going to effect the level of care I receive but to be honest it really can not get any worse at most levels. Time after time I have tried to obtain help from the "world class" services of Canada's health system and watched the door slam time after time as apparently I am too mentally ill to be helped by therapists who forgot why they entered this field.

As for the doctors and nurses all this website has asked is for them to see me as a human being and treat me accordingly. I am not a case number, I am not a thick fill that lies on the desk and I am not a diagnosis. I am someone's father, someone else's son, a friend that is always there to listen and a human being whose heart still beats. The only difference between you and me is that we are on a different path as we are both still human no matter the disguise we wear. Four years ago I was you. A loving father, husband, loyal coworker who wanted only the best for the people I worked with and my future was all laid out in front of me. Then mental illness hit and everything was thrown up in the air which ended up pushing my wife and child out the door and brought my career to a sudden halt. My future is a mystery as I am no longer able to look way down the road as everyday is a battle to see tomorrow.

As for this blog it is a little voice in a big world asking for change and maybe in the long run it will have accomplished very little but if everyone sits back and never says a word then nothing will ever change. I put myself in a precarious position along with a number of other people doing the same thing refusing to hide from a world that has repeatedly shunned us. I hope by the mentally ill speaking out it will give us a voice and remind people that behind every mental disorder stands a human being in pain and it is time for change. One in four are the odds of someone developing a mental disorder that will require some sort of treatment, one in four with those kind of odds tomorrow you could be me.

An Open Letter To The Therapeutic Community

To all the mental health professionals:

When I entered college to undertake the education required to become a social worker as I wanted to help those in a difficult position. Very early on the Professor stood in front of the class and said the following "As a mental health position you are obligated to treat whoever presents themselves in front of you regardless of the diagnosis or your personal opinions and beliefs. If you are unable to see past the problem and see the human being who needs help then you need to find a different profession". A number of people raised their hands and expressed concern about treating pedophiles, sexual deviants and people with psychopathic behavior. The professor quickly replied a human being with a mental illness is still a human being who deserves the best quality of care that a worker can provide.

A diagnosis is just a tool that is not being used effectively in too many different offices and hospitals across the world. A specific diagnosis is to be used to create a proper treatment plan guideline but not to be used to classify and rule out certain mental disorders and the human beings attached to them. Three years ago it was very easy to find a therapist as my diagnosis was severe major depressive disorder, generalized anxiety disorder and post traumatic stress disorder so it was just a matter of finding a professional with an open slot. Since my last hospitalization the search for a therapist has gone no where as now I have the borderline personality disorder label and I am automatically ruled out before the first appointment can be booked. I have reached a point where I am going to have to hide the BPD diagnosis which is not right but the chances are this is the option I will have to take in order to get the assistance I need to get my life back on track.

Remember why you decided to join this particular field of work and chances are it was to help those in need. Yes treating people with Borderline Personality Disorder is a challenge and can require a lot of work but at the end when this person is in a safe and healthy place the reward will remind you why you chose this career path. I am a father, a son, a friend and a person who has devoted his life to helping others yet when the tides suddenly switched I became a walking diagnosis and no longer seen as a human being who deserves help.

How God Turns Into The Devil

When you begin to study social work or any other form of a therapeutic profession the first thing the professor tells you is that some of your clients will fall in love with you. What the teachers fail to mention is that this endearment can switch in a heart beat leading to a potentially dangerous situation.

When a person starts to see a therapist they found a person who will listen to all of their problems without judgment, a person who appears to understand the thoughts that are racing through their head and a person who can truly empathize with the pain the client is feeling. This professional is perfect and is viewed in a light that is reserved for religious figures through the eyes of the client. This helper appears to be the key to their recovery and a much better life.

The problem comes when the client does not get better for whatever the reason and the perception of the therapist changes. The client starts viewing the sessions as not progress but as of torture for bringing up memories that should have stayed buried. The client leaves the office in worse shape then they came in and now has to deal with the mental consequences of the stones turned over revealing demons that they thought were dead. Now some people who were on the brink of reality have crossed over the line where the only thing that exists is pain and anger. The person has isolated themselves from the rest of society and is living in the pits of hell deep in their own mind. Some people will end up in an emergency room or a psych ward but some go the other way and take their own lives but others see the pain that they believed the people who tried to help caused and a tragedy takes place.

Most people do not enter therapy the second a mental health problem shows up. They keep it to themselves and try everything under the bridge to get through the difficult situation. For some people the therapist is the last resort and they put their complete faith into the helper believing that with the professionals help they will kick their illness in the ass. When progress is halted it is the therapists fault at least through the eyes of someone with a distorted perception caused by a mental disorder. Now the therapist goes from being the solution to the problem and the focus of their anger. A lot of clients take this as a setback and work through it, others will fire the therapist and find someone new and a small percentage will make the wrong choice.

Every time there is a major tragedy it makes it to the front page of the news and constant rotation on CNN but what does not make the news is the number of mental health professionals who are assaulted by their clients either physically or mentally on a very regular basis. I have scars on my body from boys biting and scratching me who would quickly turn around and proclaim me as their favorite worker. Perception is everything and my can it change quickly.

Highs And Lows Of Borderline Personality Disorder

Since my last post a number of people have emailed asking for a more descriptive explanation of the different Borderline Personality Disorder self images so that is what I will attempt to do. This is also the area where a lot of people seem to confuse BPD and Bipolar disorder. Both disorders do have their high and low periods but the main difference is time where someone with Borderline may experience several mood switched though out a single day someone with Bipolar may enter the one mood frame for up to months at a time. I really have not studied Bipolar in great depth so if I am wrong again someone speak up but I am pretty sure this is right.

Keep in mind the Borderline Personality Disorder highs and lows are not really emotions but based off of perception that comes from a false self image. I think the easiest way to do this is to bring up a number of different situations and show it from both the high and low perspective as it relates to BPD.

Relationships -
A) High - The person I am with is the most beautiful, intelligent, caring, understanding woman I have ever met and I will do anything to maintain this perfect relationship. The other person should be thankful for having someone like me in their life
B) Low - This person is nothing but an aggravation to me who is constantly looking for ways to bring me down and add to the misery in my life. If I could handle being alone then this woman would have been kicked to the curb a long time ago.

- This is all talking about the same person but just a different perspective so when things are going well they are really going well but when they are bad they are really bad. I have been a number of relationships that can be measured in years that were going absolutely amazing on all levels until my brain saw something it took as a threat and I ended up in a low BPD perspective then watched the relationship crumble unless I could figure out what I saw as a threat really was not a threat at all.

Me -
A) High - I am always right, I understand the situation better then anyone else in my life especially the so called `professionals`. I walk into any room and I am immediately the center of attention for I am that good. I can walk through fire and not get burned as I am basically invincible.
B) Low - I am always wrong so it is better to lock myself in the house and stay away from people so they don`t have the opportunity to hurt me. I walk into the room and everyone stares because I look like cousin It. If a situation is bad chances are I will get the short end of the stick every time. My doctors are all against me and they keep adding more and more bricks to the wall so there is no chance of recovery.

- I am also diagnosed with Severe Major Depressive Disorder so it tends to make the low perspective very low. Neither of the above perspectives are safe as the high level I don`t think I can be hurt so I take all sorts of stupid chances. The low perspective on the wrong day has led to more then one suicide attempt.

Therapy -
A) High - My therapist understands every little thing that I deal with on a daily basis and together we have made great strides in my recovery.
B) Low - My therapist surprises me that she/he remembers my name. I have spent countless sessions detailing my life yet no progress has been made of any kind. All the sessions are a paid form of torture as all the therapist does is attack me and destroy my self esteem. I am better off on my own.

- This is how someone with Borderline Personality Disorder destroys therapists as one session they are God and the next session they are the Devil all from a different perspective of the client. The problem is even on high BPD moments nothing is being accomplishes as it is not real.

Everything in recovery is about finding that nice stable place right in the middle of the high and low where the real self image is. The first step for me was to recognize the stage I was in and doing what it took to get to the neutral position and learning how to stay there. With a lot of effort I put a buffer between someone else`s actions or words and my response to make sure my actions are coming from a neutral state and not a high or low false perspective which to be honest is a royal pain in the ass but it is getting easier as time goes by. There are still certain situations that will put me into a negative state but like I said I am in recovery and not recovered.

Living with Borderline Personality Disorder is like being drunk standing on a see saw some days and you never know which way you will lose your balance but your pretty sure it is not going to be good. When it comes to confrontations the person with BPD is more then likely in a high BPD stage and will fight like hell to stay there as the other side or the low end usually means your fighting yourself and in my case a battle to keep breathing.

I hope that this post helped cleared up the differences between the two stages and remember this is my perspective and chances are it will differ to a certain degree from other people cursed by this disorder.

Speaking of different perspectives I forgot to mention one of my favorite BPD personal sites the other day so go visit her at Avoidance Junkie for a different view into the life of someone else with BPD.

Higher Education Versus Real Education

I went to college for social work a number of years back and part of the course was to go through a wide variety of mental illnesses that we may encounter when it was time to join the workforce. A low grade depression has been part of my life since I came out of the womb so I had a basic understanding already what the disorder entailed but it was not til I suffered my crash did I really understand.

I never understood the impact that depression could have on someones life until I had to fight to save my own. I understand being in a position so helpless where suicide is not only a option but the best thing that I have seen in a long time. Emotional pain so intense that I would grab a razor to allow it all to come out and not caring if I went to far and my life spilled out of my body. I distanced myself from friends and family not because I did not want their support but I needed to simplify my life as much as possible in order to make it through the day. How do you explain to a loved one that you know that they would be impacted if you took your own life but you needed the pain to go away. That the thoughts and images flashing through your brain at the speed of a runaway train are so intense that the thought of forever silence seems like a dream come true. The strength it takes to battle depression is so extreme my body would collapse for up to sixteen hours at a time to recover. Going into a doctors or therapist office and trying to explain to them the amount of pain you are in is so unbelievably difficult at times for they just don't get it as you can not understand hell until you have walked through it. When a teenager would approach me at work to say he was depressed the dialog he presented was scattered and at times confusing but I would know he was in trouble by the look in his eyes I just never realized how bad it could get, now I know. I would never wish depression on my worst nightmare but if all the mental professionals could experience a deep and dark depression for a few hours I bet the communication in their offices would be a lot more clear then it is now as some things you can not learn in a book. I don't believe that suicide is ever the right answer but I understand the emotions that lead to it and why someone would choose this route. Think about the last time you really stubbed your toe and trying to explain the pain to two people, the first has stubbed his or her toe in the past and the second has never experienced this but read it in a book now which one is going to be able to empathize to a higher degree and quicker to understand. Now lets say with the same incident you had to describe the pain a second after you stubbed your toe and you will have an idea the difficulty it is to explain to a mental professional about the hell your going through as all you can see is the pain and not the reasons behind it or the ability to clearly describe it.

I believe that anyone who is in the mental health profession has a huge heart to want to help the people most of society has written off or looks down at. A good percentage of people who work with people that have substance abuse problems are in recovery from substance abuse and they tend to be good at what they do for they know what their clients are experiencing to a high degree so it is easy for them to relate and then help. So do I believe you need a traumatic event or personal experience with mental disorder in able to better serve their clients? No as this is not realistic but the therapeutic community always needs people who have fought and won the battle against the monsters of mental illness to help save others and make a difference. Volunteer your time, post on the wide variety of health forums on the web and do what you can for as you are helping others you also are helping yourself with the reminders of what you did to win your personal war. When I go see a mental professional for the first time I am not hoping that they will be able to cure me but I am hoping that they understand and maybe that will make my fight easier as I am reminded I am not alone which means the world to me.

Hospitalizations - 100 ways to be bored out of your mind

Every hospital is unique in one way or another so one persons experience really does not cover all of the bases. That being said what they do have in common is you will be bored out of your mind if you stay there long enough, egomaniac nurses who believe they are more knowledgeable then your doctors (some are mind you), fellow patients who you wonder why they are there and hope they stay the heck away from you.

I spent two months in the hospital a couple of years ago after Paxil put me into a nasty place where psychotic behaviors were the norm. Ever vision your own death that was so realistic that you swore you were dead so you had to hide so the angel of death would not find you? Yeah you get the picture. My self harm behavior at the time had reached scary levels, suicidal thoughts were kicking my butt so basically my life was out of control so I agreed to be admitted into a stand alone mental hospital. This hospital had four floors , the main fl