Group Therapy

During my last hospital admission throughout the workweek group therapy was offered twice a day to help people gain the proper emotional tools to help them cope with the adventures of day to day living. What would happen is the "leader" of the group would introduce a topic and slowly they would go around the circle where each person would say how this particular area was affecting their life and as a whole they would brainstorm on possible solutions. At least this is what I think happens for I tend to avoid groups like the plague.

There are a number of reasons why I avoid groups so I might as well break them down into a list:

1. Anxiety level - I tend to spend the entire time staring at the door and coming up with a hundred and one escape routes in case the occasion presents itself.

2. Attention span - Blame Sesame Street for this one. I am capable of focusing on one topic for a pretty good length of time but when it comes to multiple stories even when on the same topic my brain is heading out to left field.

3. Detailed orientated - This is just me and I need to know the entire story or at the very least all of the details surrounding a particular situation. When I was a counselor this worked out rather well but as a patient especially one in a group setting it just does not work.

4. Trust issues - Big surprise here. It took me over two years to talk about some areas of my life with the mental doctor so the thought of opening up to a complete group of strangers makes my stomach churn.

5. Black and white thinking - People with Borderline Personality tend not to do well in a group setting for to do well a person needs to be able to see all sides of the situation and basically be able to think outside of the box. A person with BPD may be more concerned with how others are viewing him/her and not the actual material being covered.

So I avoid groups and my doctor pretty much goes along with my reasoning. The first time I was asked to join a group in the hospital setting I asked what topic they were going to discuss. The lady told me the subject matter and I replied "I use to teach that when I was working" to which she gave me a rather odd look and never asked me to join a group again.

Groups are a main reason for a lot of people who have reached recovery especially in terms of addiction. It must be a good feeling to know that there is a group of people who really understand what you are going through and will support you through difficult times. (something in my brain just clicked that this blog is a lot like group therapy in a way and I participate on a number of forums which essentially does the same thing a group does ........... maybe if there was a group that met online in a chat room on X date at Y time then ........... hmmm) Take care.

An Uncomfortable Situation

My last hospital admission was in late September or early October. I had walked into my doctors office and just pulled up my sleeves showing cuts that were made with bad intentions. In the middle of a cutting session my brain decided to take a mental vacation and when I came back to reality I was in the bathroom trying to fix up the mess. Reality can show up at the worst of times hitting you with what feels like a twenty pound brick and I finally came to the realization that I had once again lost complete control over self harm. Anyway once the doctor saw the marks the appointment ended with him picking up the phone trying to find me a bed in one of the two hospitals in the city. Where I live there is one hospital devoted to mental health and a hospital that has a psych department. The first admission some two years prior I had ended up in the mental health hospital so I figured that is where I was going again. The doctor told me to wait but about five minutes later I decided that I was not ready for an immediate admission so I went home to get ready. I did all of the things that I could to get ready such as grab a bunch of clothes, picked up a carton of smokes, made sure the mp3 player was ready to go plus sent a note to my mom and ex wife that I was going back into the hospital. I then called the doctors office and the doctor told me to report immediately to the main hospital with the psych department.

Now the first hospital had a therapist that treated a number of people in the hospital a few times a week so I assumed that this new hospital ward would be the same but I was wrong. What this hospital had was a couple of women who saw all types of patients in this main city hospital and needless to say they were very busy. Now my doctor thought that a key to my treatment is to work through areas of my past so that I could move forward which is something that I completely agree with so the nursing staff set me up with one of the before mentioned very busy counselors.

I have been around enough therapists and counselors to be able to decide whether or not they are in any good and I was pleasantly surprised at the caliber of this new helper but then a problem arose. There was no set schedule when she would be able to see me as it depended on how busy the rest of the hospital was plus one of her main areas was to help patients and their families through the death and grieving process.

After our second meeting a wave of fear ran through my body as we were getting to the point where I was about to open those old closet doors in the back of my brain. Due to this woman schedule I never knew when she was coming back nor did I know how long the session was going to be so the worry was that I bring out a demon from the past and once the monster is free it tends to cause havoc in my life. If I knew the sessions were close enough together then the process of going to war with my past would not have been a big deal but I was not sure if I would be able to handle the onslaught for a longer time period. I actually approached a nurse that I trusted and asked for advice which is something I do not do normally and explained my concerns. Her response was that in the setting I was in under constant supervision they would be able to react quickly to any situation so now was the best time to do it. What she said did make a lot of sense and I decided to wait till the next time I saw the hospital counselor then tell her my concerns and then begin to open the doors to the past.

A couple of days later after this decision I hit the mental wall going full speed to the point where I had lost complete control over everything. I scratched out a note that basically said that I was falling fast and I needed help to get out of this hell. I dropped the note on the nurse's desk where more then one saw me do so then proceeded to my room to wait for the calvary. Then I waited and waited and waited. To make a long story short it ended with a very nasty self harm session and my trust level of the nursing staff being sent out the window. A couple of days later my doctor asked about the note then freaked on the nursing staff when I told him they did nothing about it.

The hospital counselor came down later on that week and I just talked about the same stuff we had discussed the week before knowing that there was no chance that I would open those old closet doors. 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.

The Power Of Music

Back when I was still working I use to supervise the variety of college students who would come in on placements. These students were taking Child and Youth Worker or Social Service Worker and the odd ball from Corrections. One of the first questions that I would ask is what type of music they listened too. Most of the students were pretty young and tended to listen to music that was current for the time but when I cam across someone older their musical tastes would be a little bit seasoned so I would recommend that they should start paying attention to music that is more relevant
to the times as it is a great way to start a relationship with one of the many boys in the home.

When it comes to rap music there is definitely a group that loves it and another group that can't stand it but when you are working with teens chances are it is their favorite style of music. Now I don't believe you need to be an expert on every single rap artist out there but it has come in handy to having a working knowledge on at least a few. My taste for rap music is pretty specific as I like older artist such as Tupac, Eminem, DMX and similar musicians. Say what you want about rap but the lyrics are full of information that can be swung into teaching the youth lessons about life.

A few years ago Eminem was still the big one out there and yes his music tends to be more on the controversial side he also is a prime example of the false self and the real self. Eminem or Slim Shady is the false self and tends to be what most of these youth almost strive to be like in certain ways but when you remind them about Marshall Mathers the real self who has struggled to get to his dreams, is a responsible parent on most levels and even though he is now surrounded by success his world is far from being perfect. Most teenagers are stuck in the battle of trying to be what their peers expect and who they really are so the difference between Eminem and Marshall Mathers is almost comforting knowledge to them as they are not alone in their struggle.

I had a young man in my care who before every quiet time would ask me in front of his peers to talk to him at quiet time (homework hour) about a certain rap song and artist. So when I had the chance to go up to his room right off the bat he would ask about a certain part about Tupac's life and with my assistance compared it against his own. The other part to this is he could not say something was troubling in front of his peers so he used the music excuse to get me to his room where after a thirty second musical conversation he would then talk about what his problems were at the time.

One of the most difficult about social work is establishing the relationship for the person just sees you as a worker and not a human being. On more then one occasion I was able to break the ice just by bringing up music. When the youth realized that we shared a common interest it allowed him to drop his guard so to speak where he became more open and in a lot of ways seem to feel safer.

A lot of parents make the mistake of ruling their child's music taste off as garbage without trying to understand why they prefer this music. The reasons can vary from it is what their friends like so they are trying to fit in or there is something that the artist is saying that they can relate to. My father hated my taste in music especially when I was into (and still am) Seattle grunge. He complained that it was just a bunch of noisy instruments and people pretending to sing by screaming but what he did not get is when Layne Staley of Alice In Chains was singing about being stuck in the black hole of drug addiction to me he was relaying the way I felt about the trap that I was in when it came to depression that I did not have the ability nor felt safe enough to discuss with my parents. The question should not have been "Why do I listen to this garbage?" but "What makes this music so important to me".

Every once in a while a youth would show up with a song that I could not get my head around for whatever the reason so I would ask the child to copy out the lyrics for me so I would be able to better understand. The funny thing about music is once you get down to the lyrics most of it is pretty much the same. Take care.

A Depression Cure?

I found this article on MSNBC tonight and decided to pass it on:

‘Brain pacemaker’ could ease depression
Two large studies show deep brain stimulation helps severely depressed

CHICAGO - Two of the largest and longest studies so far show a “brain pacemaker” can effectively treat depression and obsessive-compulsive disorder, researchers said on Friday.

Devices implanted in the chest, with leads that send electrical impulses to parts of the brain, have already been approved to treat movement disorders, such as Parkinson’s disease, essential tremor and dystonia.

Dr. Ali Rezai, head of neurosurgery at the Cleveland Clinic, who led the studies, said the technique known as deep brain stimulation helped the most severely depressed patients improve significantly.

Researchers from Butler Hospital/Brown Medical School, Massachusetts General Hospital and Harvard Medical School were also involved in the depression study.

Seventeen paarea of the brain and is likely to generate similar findings.

He said there were no serious side effects in using the Medtronic device.

The trial treating OCD included 26 patients who were followed for three years and also showed marked improvement.

Butler Hospital/Brown University, University of Florida and University of Leuven also contributed to the OCD study.

Medtronic has an application before the U.S. Food and Drug Administration for approval to use deep brain stimulation for OCD.

A clinical trial using the treatment for severe depression will be initiated this year.

The FDA in 2005 approved Cyberonics Inc implantable device for treatment-resistant depression. It sends signals to the brain via the vagus nerve in the neck.

Original post on MSNBC

To be honest I am not sure this is something that I would be willing to try but heck catch me on the right day you never know. I have gone through countless amounts of different meds and numerous sessions of Electro Convulsive Therapy with nothing really being effective long term. Maybe this is the missing piece of the puzzle but the chance of this treatment being available north of the border is probably not very likely especially in the area that I am currently living in.

So the question is my wonderful readers is if your doctor offered you this treatment would you accept? Take care.

The Problems In Running A Mental Health Blog

Over the last few days I have visited quite a few mental health blogs and a number of them are either really slowing down in the number of post or have announced that they are taking a hiatus. I think that every mental health blog tells a unique story and can go along way in the fighting the stigma of mental illness but there are consequences to maintaining a personal mental health site.

1. I find to really connect with the reader it is important to share all of the facts and the emotions regarding a specific event or events. The problem with this is focusing on the past can bring up emotions that may have not been properly dealt with and send the monster back into motion. On more then one occasion I have started a post that I felt was important to cover but realized half way through that this was not a good idea for me mentally.

2. The reason for posts on this site to suddenly switch to a poetry day or information about this blogs performance is mentally I need to take a break from digging through my head. I can not allow my brain to stay in an area that for lack of a better word is risky and every once in a while I need a little mental vacation.

3. The majority of the posts on this site have been told to a variety of doctors, nurses, therapists and other mental health professionals so by the time they hit this blog a lot of their power has been taken away or taken back. There are a few posts on this site that are the result of the emotional state I am in at the time and they are pretty easy to make out as they tend to be all over the map which was the state my brain was in when I wrote the darn thing. I fight the urge to delete this type of post later on but I don't as I believe they really show the effect of long term mental illness as one moment I am up but the next second I may be spiraling out of control.

4. Having a clear focus and mission of a blog goes a long way. This blog is meant to help lift the veil off of mental illness but at the same time it does provide me with a place to explore the inner workings of my brain. This is not my job and I have not made a cent off of this site which allows me to write when I want and about pretty much everything. If this blog was solely about one mental illness and making money chances are this conversation would have ended a long time ago as the second you force yourself to write is when you start to lose control.

5. One advantage I have, believe it or not, is the Borderline Personality Disorder. It is rather easy for me to separate myself from what I am writing about a good percentage of the time. I can sit there and rattle off my life history with almost no emotion for in my head it is like I am talking about someone else. A friend of mine once said "Someone with BPD can talk to you for hours about their life but manage to tell you nothing". Splitting has its benefits.

I guess in the end it is about maintaining the line of what is good for you and what is good for the blog. If I felt that this blog was impacting my mental stability in a negative fashion then it would be time for me to either walk away or reestablish my priorities when it comes to this blog.

As I mentioned earlier I believe every mental health blog offers something in the war against the stigma of mental illness as they tell the story that matters. Don't judge us because of our disorders but take the time to see through the writing and see the human being who is fighting this particular type of monster. Hopefully through our journals written out on the web in the end we will make a difference and help others who are wearing similar shoes. Take care.

An Odd Relationship

Every time I meet a new doctor or a new therapist they automatically focus on the death of my father as the reason behind the breakdown. After a couple of meetings they come to realize that the death may have been the breaking point but the storm started decades earlier.

I hated my father for a really long time and it was not till my early twenties did our relationship start to go in a positive direction. When I was in my teens I use to have this fantasy every time I left my house that I was escaping from a prison as that is what it felt like. For the longest time I would never know why or what would set my father off as it constantly seemed to change so I stayed in a hyper vigilant state always ready to react.

Over the years I have forgiven my father for basically everything and have tried to justify his behavior. My father grew up in a abusive household, he went through a number of strokes that seem to change his personality and some of my behaviors needed to be dealt with or else I may have cycled out of control are some of the reasons or excuses I have used to just let areas of my past go but some parts I just can't justify no matter how hard I want too.

It must sound odd to people that one day I am describing my best friend and the next day talking about a monster yet they are the same person. At seventeen in the middle of a heated argument I threatened to kill him and their was no doubt in his mind that I was capable of doing so but by my mid twenties I would have given my life to save his. This is the key part of the relationship that I still struggle with and the question being "Why did my father become my dad and best friend in my twenties and not from the start?".

My dad and I use to go out for coffee a lot over a couple of years where I learned more about him then I had in the previous two decades. One day he said that before I was born he wanted to be the best father possible and not repeat the mistakes that his father made but his efforts were not good enough and once past a certain point he would resort back to what he knew best which was violence. My dad use to stress that it was very important for me to break the cycle of violence which I have done and continue to do with my son.

I wonder sometime how I am going to answer my son when he asks about my father who passed away before his birth. Should I tell him about the man who is responsible for a fair portion of my current mental illness or should I tell him about the man who I have missed every single day since he passed some six years ago. I imagine the answer is somewhere in the middle. Take care.

The Extreme Treatments

Once you get to a level where medication and therapy are not doing the trick there are some options left on the table.

The first one is Electro Convulsive Therapy or what use to be known as shock treatments which I tried to cover through my experiences yesterday "Shock Therapy Still Alive And Well". The video below shows this treatment and how it is done today:



Another option in some ares is Deep Brain Stimulation which is a surgical procedure where a device is placed in the patients brain. The battery is placed just below the clavicle with a special wire joining the two. This therapy has been used with good success with people suffering from Parkinson's, chronic pain, dystonia and tremors. There have been studies showing success with DBS and chronic depression but the studies were small inside so an accurate success ratio is really uncertain. I think in the years I have spent online in various forums there have been maybe a handful of people that have undergone this procedure. This short video (under thirty seconds) shows the layout of the device, battery and wire.



The third rather extreme treatment is Repetitive transcranial magnetic stimulation. Where rather large magnets stimulate certain areas of the brain which helps some people over come depression. The drawback to this therapy is that it can be expensive, not a lot of places over it and the mental health professional community has not been overly acceptant of it. This link is a company that offers the service and they claim the success numbers are high but actual numbers are a little bit harder to find.

So there you have it. If any of my readers have gone through the second or third option I would love to hear from you and the results that you had. Take care.

My Quirky Personality

I have an addictive personality and this is something I recognized a long time ago so I am pretty careful around anything that can become habit forming for the most part. A part of this lead to this blog at first it was just a way to release all the pent up garbage I carry with me and the hope someone will understand but pretty soon it grew to an obsession. Checking the traffic sites on an hourly basis and trying to figure out new ways to find new readers but like the majority of my life there was no much reason behind this drive. I don't make money off of this blogs so what difference does it make if I get one visitor per day or a thousand. The simple justification is the more people who read it then maybe it will leave a mark on a number of people which then may lead to the better treatment of the mentally ill but like the majority of my logic there are a number of holes to this theory and the knowledge knowing I have set a goal that can not be measured at least with any accuracy.

Then the obsession with this blog was gone and quickly replaced with a new addiction. Now my days are spent creating what I hope to be a blanket by the end of April. I learned how to crochet when I was working in a jail for young offenders and there is something therapeutic in the process of creating something from nothing plus I am constantly counting the next row so my mind does not have an opportunity to wander which is basically what the doctor ordered.

The problem with my so called addictions is I never know how long they will last for and my residence is full of projects that will never see completion. In a way it is like my life as I have all the best intentions in the world when it comes to recovery but I never see it completely through as something always will happen that will throw me off course and once I lose sight of the final goal then that is it until I can figure out how to restart the process again. Once again I am my biggest enemy or monster. Mind you I am not the only one guilty of this and the amount of money that people throw at self improvement and weight loss programs backs this up.

A Day On The Psych Ward

Right off the bat I should mention that every psych ward is going to have its similarities and their differences. The last time I was on a psych ward it was for the month of October during 2007. This ward was located at the city hospital and its main purpose was suppose to be to deal with people in acute situations or in other words short term stays but due to lack of beds in facilities for complex situations half the patients were there for a lot longer then what the ward was designed for.

7:00am - This is my normal wake up time. I quickly dressed and left the bedroom while my three other roommates continued to snore. Normally I would grab my jacket and head out to the back deck for a quick smoke. The smoking area was a balcony that was literally caged in to prevent people from taking a flying leap.

8:00 - Breakfast would arrive. The menu switched from day to day with your usual morning food items. Coffee is all I cared for but every once in a while I would try something then quickly understood why I avoided breakfast. Around this time is when the morning meds would circulate.

9:00 - The doctors would begin to circulate. The patients would normally be sitting around waiting for the whole five minutes spent with their doctors. The typical question were (1) has anything changed since yesterday (2) How would you rate your mood (3) Any immediate concerns. Tax money well spent.

10:00 - The group therapy would begin. It covered such topics as meditation, relationship building and decision making. Picture ten people sitting around a small room all with a variety of mental illnesses though the majority were there for a form of depression and very quickly the group would be off track. I avoid group therapies for a few reasons (1) I have enough problems talking with my doctor and staff about problems in my life so the thought of telling my stories to a bunch of strangers is not exactly appealing (2) The topics that were covered I use to teach when I was at work (3) My personality works two ways in groups which is I dominate the meeting or I do not participate what so ever. I went to one group meeting during my month stay and it was mandatory for those going out on a weekend pass, the topic was what you hoped to accomplish with your brief trip home - my priorities were pretty obvious: spend time with my son and enjoy the visit with my mom who traveled six hours to give me a break from the hospital.

11:00 - Nothing scheduled.

12:00pm - Lunch. The food was pretty good until I was put on a diet for MAOI (antidepressant) then it was basically the same damn thing everyday. The afternoon meds would begin to circulate.

2:00 - Some sort of group activity Mon - Fri. Bingo, arts and crafts and what have you. The majority of people did not participate including me.

5:00 - Supper. See lunch.

7:00 - Another group therapy sessions but tended to be under half an hour.

8:30 - Snack.

9:00 - The night time meds would begin to go around.

10:00 - Bedtime for me.

Free time - There is a lot of free time on the psych ward. Some people spent that time in front of the television, others sat in little groups basically complaining about their situations, a small percentage spent the majority of the day in bed. I decided to write a book so if I was not working on communication with my doctor through letters, essays then chances are I was writing my book. I think I averaged close to eight hours a day on my book (that I have barely touched since my release)

Smoking - A lot of people on the psych ward smoke. If I did not smoke then chances are I would have never gone outside. A pain in the ass is there was patients whose cigarettes were on a schedule so they would be constantly begging others for smokes which the nursing staff completely frowned upon but some days fellow patients would give in just to have a moment of peace.

Security - There was a security guard on duty from Monday to Friday between 7am to 11pm. There was no security of weekends for I guess people do not go crazy on weekends.

Nurses - They ran the scale. They were some nurses who constantly went out of their way to help the patients and then they were nurses who you would see only at med dispensing times.

Therapy - The psych ward did not have a therapist. There was a grief counselor who came in once in a while. This lady was really good but she was stretched way to thin as she was responsible for pretty close to the entire hospital. I think I saw her three times in the month that I was there.

Incidents - People losing control of their emotions for whatever the reason was pretty common but the nurses quickly led them back to their rooms so as not to effect the other patients. There was one major incident that lasted close to three days off and on. The patient would go from somewhat calm to completely freaking where she would scream, band the walls, tried to destroy her room and what have you. This incident effected every other patient on the floor as no one knew what she was going to do. The protocol was to bring her to another hospital that was better equipped to handle someone of her need but there were no open beds to do so. Eventually they gave her enough drugs where she would be quiet for eight hours or so then the situation would repeat. I basically signed myself out, my doctor agreed with my logic, as the anxiety from this one person was not helpful to my mental condition plus it became rather apparent the hospital was not designed to deal with someone of my need.

Overall - The psych ward is a rather boring place to be and you spend a lot of time in your own head trying to figure things out on your own. The thing with psych wards is that people tend to feel safe there as the staff are always right around the corner so after a while the real world gets more and more intimidating which causes some patients to exaggerate their mental illness to ensure a longer stay. Unfortunately this psych ward was designed to just deal with the crisis and not the overall problem so people leaving then coming back within a six month period was pretty routine.

Solution - The obvious one is money for longer term beds, one on one therapy and to switch the thinking from medicate to therapeutic treatment as band aids do not last very long.

take care

Searching For Positives

A few hours after the initial reaction to the doctors appointment I began to think about what he said. His theory about therapy being useless as the second someone crosses an invisible line then I would completely shut down may have applied a while back but it really does not carry any water now. The best example of this would be when the jack ass always turns to "Your too borderline for treatment to be effective" for that statement challenges every inner boundary that I have but it does not get a reaction from me, well besides me thinking my doctor found his degree in a cracker jack box. See that statement, at least to me, says that the disorder has control and not me which the BPD brain would interpret as being weak so chances are it would set off a rage in the untreated BPD brain but when he said it to me it brought up nothing in terms of emotional response. According to my doctor I am untreatable but to me this is a sign of progress even if my doctor is to blind to see it.

Take care.

What To Do Now

Had a doctors appointment late this afternoon and like normal I left a lot more frustrated then I walked in. The doctor has his mind set on me returning to the MAOI antidepressant class and he is willing to wait a good number of months until my dental work is complete of course this is easy for him to do as he does not have to live in this chaos that I call life.

He asked what I am going to do to change the situation and my frustration towards the therapeutic community in this city came flying through. The doctor said therapy would be a waste of time because in his words "I am too borderline". His theory is that once the therapist says something that I do no like that I would stop listening and would end up fighting against the professional. Which is a complete load of garbage but my doctor deemed me untreatable a long time ago and nothing is going to change his opinion.

The bright idea that the doctor came up with is I need to get involved in some sort of job or volunteer capacity that would not allow me the opportunity to think. I responded that the work I want to do is what I use to which is social work and the brilliant doctor responded as long as I could concentrate on the other persons emotions and not my own their should not be an issue. Neat trick walk into a situation that caters to young people whose life stories are very similar to my own and not be triggered, this suggestion is not only dangerous for me but for anyone who happens to cross my path as the main issues behind my illness have not been dealt with to a level where they are no longer a factor.

So why is he still my doctor? The simple answer is I need the prescriptions for Seroquel and Temazapam for some kind of order in my life and if I fire him I then have to go on a waiting list for another doctor which could be a very long time. Also every doctor in the city works out of the same office so not much point. He actually said I should stop any behavior which would lead to me thinking about the mess in my head which means this blog is history plus the numerous forums that I participate on which is essentially my support system. Doctors. Take care.

What I Am Working On

This blog is the closest thing I have to therapy in my life at the moment so I guess I should be setting goals to give a clear idea of what I am working towards.

1. The relationship with my son. This is a very long term goal that will last until I am no longer part of this world. I had a very good relationship with my father for the last five to six years of his life but before that it was a disaster. I want my child to be comfortable to come to me for anything and I never want him to question how I feel about him. This sounds like a typical parental answer but it is something I never had until I was in my twenties and my father never had with his own father so it is time that this cycle is broken

2. Swallowing of emotions. I need to stay focused on the way different events or situations effect me and deal with them when they arrive and not turn back to the old patterns of just avoiding anything troubling. To a point I am able to do some of it here but I think it is time I start journaling in a fashion that is not so public and really get to the root of every problem instead of just trying to make it go away.

3. Not accepting my situation. I need to keep fighting towards recovery and not get complacent with my situation. It is too easy to just accept my current place in life with the belief that it will never change. This is not the life that I want so I need to fight harder to get the life I want.

4. Not everything is a fight worth fighting. This is a Borderline thing as I tend to take simple comments as a personal attack which then end up going really badly. I need to make sure that I take the time to see someones actions or words from all angles to really determine where it is coming from then respond appropriately. I have come a long way with this but it needs to be extended further.

5. I need to find out why I do not like myself and change that mindset. My battle will be a lot easier if I was fighting for a life that I believed deserved to be saved and not the belief that I have now. The difficulty in this area is I am really not sure who I am. I see myself in the high perspective of BPD and everything is good then I see myself from the low perspective and nothing is good. I need to find my real self which is somewhere in the middle and learn to accept this person instead of keeping him hidden. This is going to be a neat trick but it needs to be done.

As for this blog I actually like the way it has gone so far for the most part. There have been posts which to me at least hit the nail on the head and then there have been times where I was really unsure where a post was going and spent a lot of time afterwards debating whether to keep it or not. The reality is this is very similar to my life at the moment where at one point I appear to be in complete control and the next fighting to find a rope to hand on too. A main feature of mental illness is the tides of emotions can move quickly from one extreme to the next especially when Borderline Personality is at play.

There you have it my five main goals right now. I just need to figure out a way to make sure it gets done

Special Treatment? Nope

Last week a question showed up in the comment section of this little ole blog and I have been struggling to write about it ever since. The question was basically how does my prior occupation as a mental health worker effect my current situation. The simple answer is it probably hurts more then it helps but the explanation why is not so easy but I am going to give it a shot .... again.

1. The standard approach nurses and other mental health professionals use regularly does not work on me so either they need to find a new way of taking on the problem or just take the easy route and ignore me. The latter happened a lot more often and I have a funny feeling it is all about ego. Various workers are use to the clients believing everything they say whether it is appropriate or not. This does not work with me as my education, experience in the field and my own perception knows better. A typical approach of all you have to do is focus on the positive and charge forward may make sense to someone who has never dealt with mental illness before but unfortunately I am all to familiar with the reality of poor negative mental health and it is no where near that simple.

2. This ties into the first one and probably has something to do with the Borderline Personality area of my brain. I find myself constantly analyzing the helpers approach and spend too much time deciding whether or not if that is the approach I would have used instead of actually listening to what the person is saying or trying to say.

3. What I represent. Mental health workers have a pretty good chance of suffering burn out sometime during their career and to a lot of other helpers I am a reality that they would rather pretend did not exist.

4. There are small areas of dealing with mental health that the newbie can just ignore and keep going, something I am not able to do. I pretty much recognize every symptom of mental health as an indicator of a larger problem which ends up setting me back in terms of recovery. For example someone new to the situation may have a small bout which they may think of as a deja vu experience and just let it go where I see it as an indicator of psychosis which my brain can't let go and I end up building it up into a much larger problem. The whole ignorance is bliss applies here

5. One of the most difficult parts of my illness is a simple question that tends to haunt me. The question is "How come I can help darn near anyone who crosses my path yet when it comes to my own brain I am basically useless?". The answer is simple as it is all about attachment and emotion which I fully recognize but still does not make the question go away. I am able to analyze the hell out of my mind, the various thought processes and anything that is not quite right but my hands seem to be tied when it comes to treatment. My gift and my curse according to the doctor.

At the end of the last hospital stay I wrote a letter to the nursing staff which basically thanked them for trying to help and I even went to the length of naming certain staff members and expressing gratitude for specific situations. A line from that letter was "As a former mental health professional I did not come into the hospital expecting special treatment I just wanted help".

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.

How I Diagnosed Myself

Back in October of last year I was sitting in a hospital bed trying to figure out a way to get back on the road to recovery and the decision I made was to put absolutely everything down in written form then hand it over to my doctor.

The first time I took on this process I just ran through my life without giving much detail more of a glimpse through the window into my soul. The doctor was overly excited about this written material and he claimed that he learned more by reading five pages of writing then he had in the previous two plus years. I took this as a positive sign so I set out to write version two of the same story but a lot more detailed but again not the complete story. Once again the doctor responded that I was making great strides by focusing so much on the areas in my head that I was moved to write what turned out to be my complete profile or as complete as I was willing to share for there are parts of my life that I am still unable to talk or write about.

This third book broke my complete life down into sections and how I dealt or didn't deal which each part. For an example of the intensity involved it took the section dealing with my fathers death was about a page in length but it took me three hours to write it. After I had completed this book, each day I would hand my doctor a couple of pages, my doctor said "every time you meet a new doctor or a new therapist give them this journal and the success of the relationship will be greatly improved". My doctor then replied in his history as a doctor he had never had a patient who was able to go into their brain and analyze the way that I am able to do. This was a huge ego boost but didn't last long for he then came back and said "this is your gift and this is your curse as your brain just can't leave anything alone so your constantly reliving events instead of putting them to rest". I thought about what he said then I decided to create my own treatment plan thinking no one knows my mind like I do so I am the best person to plan out the route to recovery.

I wrote out this treatment plan where I listed out all of my issues both present and historical then I wrote out a recovery solution but I made a critical mistake. At the top of my treatment plan I wrote out what I believed my diagnosis should be and what had already been confirmed. The two confirmed were severe major depressive disorder with psychotic features and post traumatic stress disorder. The two left were generalized anxiety disorder and borderline personality disorder both of which my doctor agreed on a little bit too quickly. Then for some reason things began to get weird as our discussions were no longer on recovery but of me remaining stable. A week or so later I wrote out a plan of what I needed to do to get better and the doctor fully agreed then said there was no chance the hospital would be able to provide it, I asked for an intensive therapy program, so I asked to be discharged to get the help in the community and again he agreed. I saw him a month later and told him how no therapist would even let me in the door and the doctor replied this is not a surprise as you are too borderline for therapy to be effective. Which means I am untreatable in english.

The part that still bothers me is I wonder what would have happened if I had never brought up the Borderline diagnosis would it have came to the surface. Was my doctors fast reaction due to him wanting to say it earlier but didn't for whatever the reason or did I answer a lingering question that was already on his mind. The other part is how on Thursday I am making great strides to recovery but when the Borderline diagnosis came up on Friday all of a sudden I was untreatable. Common sense just does not work when it comes to mental health apparently.

In case your wondering about the accuracy of the diagnosis I meet eight of the nine of the criteria so not only do I pass I pass with flying colors. See this past article for a breakdown of the criteria

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.

Mountains From Mole Hils

It seems every time I turn around there is a new website promoting the cure for anxiety. For only $19.95 this self proclaimed expert will teach you the various methods where anxiety will no longer be an issue in your life. So why are there so many sites? Anxiety disorder is the top mental health problem in the USA with forty million people effected every year so the consumer base is pretty high.

Anxiety is normal to a certain point. It is what fuels the fight or flight button in or brain that is designed to keep us safe or at least safer. Of course to me Anxiety is like Depression in one word does not do a very good job of covering an entire disorder spectrum. This one word somehow covers the jitters you get before an important meeting or a first date or trying to explain to your parents how you just wrapped Dad's prized possession around a tree. Anxiety also includes being so afraid of the outside world that you never leave your house or anxiety attacks that are so severe you swear your going to die or flashbacks that are tied into Post Traumatic Stress Disorder that will send you back into your person hell in a heartbeat or a phobia so strong that there is no way in hell are you going to confront it. One heck of a spectrum for one word.

How do you get over anxiety or at least lessen the impact it has on your life? Well first you send me a check for $29.99 and I will tell you, just kidding. The key to plain old anxiety is figuring out where it came from which is a lot harder then it sounds. Joe Blow is scared to leave his house because the one time he did a pack of rabid squirrels bit him on the ass so he now believes this event will repeat so he sentences himself to house arrest. This may be a extreme example but I can guarantee the situation, well maybe not the part of the squirrels, applies to a group of people. The key to therapy for this situation is for Joe to be able to understand what happened to him was a freak occurrence and it is not what is to be expected when he steps outside his home. The longer the anxiety has been present the harder it is to treat for over time the mind tends to make mountains out of mole hills.

Here is another group example and that is people who are terrified of the dark which is a pretty large group. Is it the fact that there is no light in the room that scares this group? Yes and no. The dark scares them but it is not the cause as chances are something happened a long time ago in a dark room that set this particular anxiety off. They are not afraid of the dark but they are afraid that something that took place in the dark will happen again a lot of people who were sexually or physically abused as children are terrified of the dark. Understanding the root of the anxiety is the key to overcoming it.

Anxiety related to health problems is so unbelievably common it keeps doctors and emergency rooms busy. The drawback to the internet is that there is too much information available which just makes a bad situation even worse. Across the forums that I participate on I see it constantly. People taking one thing such as a worry that their friends do not like them and before you know it they believe that they are now the proud owner of a Borderline Personality Disorder diagnosis. My response is always the same thing go see a doctor to get a real evaluation done then start to research the problematic behavior and not the other way around. The part that always get me is I see people post about a specific condition for awhile then when you ask if they have seen a medical professional the answer is no. To me the doctor is always the first step and then I go from there. Ever been tested for HIV? What is the worst part? The wait for by the time the results have come back you have completely convinced yourself that you have this terrible condition but when the test comes back negative you feel on top of the world and a little bit stupid for allowing yourself to think the way you did. The majority of health concerns can be ruled out with a visit to the doctors and waiting a week for the test results is a lot easier on the body then a self diagnosis which is just asking for trouble. As soon as a question appears in your mind find a doctor to answer it for you and stay away from medical sites until you have a firm diagnosis.

My worst anxiety attack occurred before I had my breakdown. I was recovering from shingles and my throat was sore so I did what most people do and looked in the mirror. My throat was a different color then normal and for whatever the reason I thought it was swelling. I tried to ignore it but my brain would not let it go and for some weird mental reason I believed that I could no longer swallow so now I was breathing heavily through my nose. A quick trip back to the mirror and now I was convinced that my throat was swollen shut. Mentally I was long gone by this point and started to hyper ventilate to the point where my ex drove me to the hospital. On the way there I was struggling to breathe and at one point she wanted to stop at her work to call an ambulance. We get to the hospital and my ex convinced a nurse I was a couple of steps away from dying so I was immediately rushed through. I was in one of the little rooms still struggling to breathe when the doctor came in and he examined my throat then said yes it was red but there was no signs of it swelling shut and no logical reason why I could not breathe normally and do you know what all of a sudden I could breathe again. The mind is a powerful device that can convince you that your dying when your perfectly fine. Save yourself the anguish and stress and go see your doctor to answer that question that will not go away on its own.

There are many forms of anxiety disorders from Generalized Anxiety Disorder to Social Anxiety Disorder to Post Traumatic Stress Disorder to Panic Disorder to Phobias to Obsessive Compulsive Disorder to Agoraphobia and a bunch more. The best thing to do is get a firm diagnosis, develop a treatment plan and then go to work on it at least this way you know exactly what your dealing with instead of wandering around in circles. My anxiety is in check at the moment due to a whole hell of a lot of meds but I know the only way to lessen it on a permanent basis is to get to the route of the issue but being Borderline means no therapist is willing to come near me so I am relying on the band aid that is medication to keep the bugger at bay.

Armed Forces Suicide Prevention Act

I promise to write 99% of the material on this particular blog but every once in a while I cross an article that I think I should share. I have addressed PTSD and the incredible rise of suicidal behavior in the military here and this new act that has been introduced to the House of Commons or what ever you Americans call it. This is a very important act but like the new campaign by the military for depression it should have been done a long time ago.

The following article was taken off of the Suicide Prevention Action Network USA

On January 31, 2008, Senator Tom Harkin (D-IA) and Senator Chuck Hagel (R-NE) introduced the Armed Forces Suicide Prevention Act (S. 2585).

Recently, the Department of Defense (DoD) has reported an increase in suicide among active duty troops. The Army is experiencing the highest number of suicides and suicide attempts on record. In addition, the DoD Task Force on Mental Health estimated 38% of active duty soldiers and 50% of National Guard who have served in Iraq or Afghanistan report mental health issues, and that neither the VA nor the DoD is ready to deal with the increase in mental health needs of Iraq and Afghanistan service personnel. Suicide prevention for active duty personnel serves not only to prevent needless deaths during enlistment, but also after members are discharged, preventing suicide among our veterans as well.

Comprehensive programs that address risk factors have been proven effective. In the early 1990’s, one in every four deaths among active duty Air Force personnel was from suicide. The Air Force implemented a suicide prevention program, and by 2002, the suicide rate had declined by 33%. Researchers also found a decrease in violent crime and family violence after program implementation.

The Armed Forces Suicide Prevention Act will require the DoD to implement comprehensive suicide prevention programs within all branches of the military, including the National Guard and the Reserves. The bill includes provisions to provide training and outreach to personnel, encourage help-seeking, and prevent suicide among those who have dedicated their lives to keeping our nation secure.

SPAN USA encourages you to take action and ask your senators to cosponsor S. 2585- the Armed Forces Suicide Prevention Act.

- To my American friends do what you can to get this act pushed through as fast as possible. The number of suicides and suicidal behavior is not going away anytime soon and it is time to protect the men and women who put their lives on the line to serve your country.

Buddy You Have A Problem - Intervention Do's and Dont's

I was watching Intervention on A&E last night, which was a repeat by the way, and the thought that was going through that head of mine is I wonder how many people try to intervene on a family member or a friend after watching this program for they make it seem so easy. Right away interventions have the potential of going very bad very quickly with results that can be much worse then the original problem.

Visualize how you would feel if you walked into a room and every single person in there was staring at you. Needless to say a lot of people would feel very anxious which tend to lead to a defensive stance so already this process is not going well and the addition of a camera crew really does not help but I would imagine is the reason a lot of people agree to it. Now the person is asked to take a seat and the moderator goes through the basic speech on how every one in this room is concerned about your welfare so they are going to tell stories on how your messing up. If it was me this is about the time I am staring at the floor preparing my reaction and not hearing a damn thing people are saying but that is me. Everyone in the room tells their story and now they want you to agree to whatever the plan is. Most people have that part of them that wants to make others happy so they agree to what ever the suggestion is. Now if this is what the person at the center of attention wanted then the chance of recovery is much greater but if the person is getting help to please others then the outcome is not so good.

What people need to keep in mind that what this show does along with most professional intervention services is that whatever the desired outcome happens to be is in place. If the family and friends want buddy in rehab then all of the paperwork and other garbage is taken care of and they are just waiting for the person to show up. If their is time between the intervention and the entering of the program it is not going to work for the last thing you want is to give the person time to think about their decision. When it comes to substance abuse the person may go off to to get drunk or high for the last time and this can be deadly for they want this time to be one to remember and th