Three years and Four months

In November 2016 I was admitted to an adult mental heal unit for the 17th time that year. I had let my illness consume me, all that I was had seemed to disappear and the only place I could be safe was in hospital. Three years and Three months ago I was discharged and I never went back, I engaged in counselling, took my medication, used outpatient services but with the support of family, friends and professionals I began to claim my life back and rather than be sad that I had to live with mental health issues I was angry and I was not going to let my illness steal anymore of my life from me.

In that time I went from being told by a doctor that the reality was I would eventually take my own life to having no more suicide attempts or self harm.

In that time I went from being told I would always struggle with relationships with other people to strengthening the friendships I had and making new ones

I went from needing medication to needing no medication, from needing interaction with services to needing no interaction.

I went from being told I would be signed off work sick forever to holding down a full time job with ease.

I went from being Borderline to being recovered

The way I write those things may sound like big deals, which in some way they are and they are things I can celebrate but this is just the reality of recovery and is the same for anyone on the journey to recovery. It didn’t mean that life was easy and that I didn’t have any symptoms or struggles with one of my diagnosis but it meant I had a way of dealing and it not longer consumed me and I found who I was again, separate from my poorly wired head organ.

The past 2 months I have been dealing with a different part of recovery (because that is what it is), Relapse. I began to get ill and things spiralled quickly to the point a couple of days after I first felt the symptoms reappear I looked myself in the mirror and told myself I was no longer in control. I stayed out of control cycling quickly, falling deeper into my depression and sometimes flying into hyper mania without noticing my feet wernt even of the ground. When I realised that I could not work whilst in that state I rang for help and was put on home visits each day to make sure I was staying safe and for about 3 weeks I did.

I thought I was getting better and went back to work, picked up my normal routine but I was not better, I had found myself in the eye of the storm it seemed chill, calm almost, like normal just a bit darker but then the storm hit me, full force and I was no longer me. Something in me changed and I decided I would give way to whatever my illness wanted. I didn’t want to fight it anymore because I felt like a failure, I had failed in my recovery, I was worthless, I was not made for this world, I had failed to be a person and now whatever happened would happen. In this time I was still adamant that I was OK that things were harder but I was OK and this was not a relapse, I was not Ill, they were dirty words that only added fuel to the fire of my failure.

I encountered a trigger, it may have been small but I could not deal with it and it made me explode, the home treatment team came for there visit and I told them I was fine but they were worried and came out again later in the day. I told them to leave. I told them I was fine and did not want there help, that I was getting better, I was back at work and doing things I was meant to and that they should get out of my house. Looking back I was rude, arrogant, a liar, but mental illness can change my personality. They said ok and they left the house and I thought that was the end of it. I’d already taken a lot of pills that day so I (for some reason which probably illustrates how out of it I was at that point) cleaned the house from top to bottom, did my hair and make up and got dressed up and then sat in my room, got everything organised I needed and set about ending my life. At the moment, not even exaggerating for dramatic effect, literally at that moment there was a knock at my door and there stood two doctors and a social worker. If you’ve been involved with mental health before you know shit is going down when you see two doctors and a social worker. They spoke to me for what seemed like forever and I lied my why through, argued my way through, thought I’d done a good job of showing them just how fine I was until they told me they were writing “pink slips” I have never been more angry or cry shouted so much but it did me no good and I was put on a section 2 and transported straight to a inpatient unit.

I spent 9 days at the unit being angry. How could they do that to me? I was fine? I was getting on with things? It was nothing to do with them that I was hurting myself, surely that’s my right? Why have they got the power to ruin my life? I wasn’t even that I’ll, why did they even bring me in?

It has now been 2 weeks and it is only now that I am ready to acknowledge what happened, accept it and take back control of my own recovery, I have 6 days until I am discharged and I plan on working to make sure I am able and on it when I come out!

I am saying this, not because it’s just a story to tell but to say it is OK to relapse, it doesn’t mean you have failed, it means you’re unwell, or something is wrong that needs addressing. Radical acceptance is accepting myself/yourself in the worst days as well as the best days and understanding that mental illness is not you but a part of you.

If I had had that mindset that maybe things would not of gone so far, I would not of been scared to admit my relapse and might of got help sooner, I defiantly wouldn’t have been in hospital as long because I was wasting days being angry with the situation and myself.

Rather than being angry that after more than 3 years there has been a life halting relapse, it’s time to celebrate that there was 3 years well and it is not impossible to have that again, but accepting myself is the only way I will have that again.

The hardest thing to deal with this time round has been the shock, the shock that I was ok for so long and then suddenly wasn’t, it was shock, guilt, fear and an overwhelming sense of failure that led me here.

But to myself and anyone else that needs to hear it, you are strong, you are enough, you have not failed and you can ask for help. I have questioned myself a lot the past week, does this mean I am ill again forever? Am I strong enough to do this again? Brace enough to rebuild myself again? Do I have the hope that that’s even possible? I may not know all the answers but I do know that so far I, we, have lived through 100 percent of the worst days and I plan to live through the rest of them, holding out for the good days knowing that eventually there will be more great than terrible, there will be more average than difficult.

Fighting with Food.

I’ve never been a normal weight. I’ve always been big. When I was 5 I weighed 5 stone, and every year I put on another stone until I was 14 stone at 14. After that I started to try and do something about it for myself, I was motivated for myself rather than other people telling me what to do. I became the queen of yo yo dieting. At my lightest I was 11 stone, my heaviest 18.

Funny thing is I don’t particularly remember being an unhealthy child, I don’t have recollections of eating too much or eating junk food, I remember looking at my thinner friends at meal times and thinking “you eat three times as much as me, why am I the fat one.” I may not remember how I got that way, but I do remember what happened as a result of it.

When I was 5 my school sent me to a dietician, I was told I wasn’t allowed seconds at meal times and wasn’t allowed puddings at school. I was never bothered about losing the food, what I was bothered about was the isolation. I was 5 and I was already different to everyone else but I didn’t lose any weight.

When I was 10 my mum took me to weight watchers. She’d send me off to school with i box of lettuce (literally) and I’d weigh in with the adults every week. I never lost any weight.

When I was 12 I went on slim fast. I took milkshakes for packed lunches and ate salads for dinner every day, I still never lost any weight.

The reason I didn’t lose weight was that I ate in secret, I was and still am an emotional eater and even worse sometimes a bored eater. At those young ages, I was already unhappy, and the thing that distracted me from that was food.

But then something changed. At 13 my mood was even lower, I suddenly wasn’t just a bit sad, I was depressed. I wasn’t struggling with puberty, I was struggling with my existence. That’s a tension that takes more than food to release, that’s also when I found self harm. Suddenly I didn’t need food to calm the emotion anymore, I had a new way. So I started dieting, really dieting, i did every quick fix in the book and learnt all the tricks. I was determined and I was going to be thin. Little did I know then that that was just another coping method, another thing for me to obsessively control. But, I did it. I lost the weight.

Then disaster struck, my self harm was discovered. My mum ran through the house and collected anything I could possibly hurt myself with. She checked by bags after I’d been shopping, there was no where to hide anything. Suddenly my coping mechanism was gone.

So I ate. I ate a lot.

Then I felt guilty I’d messed up my diet. I felt ashamed I was so weak. I felt horrified at the disgusting person I thought I was.

For the first time I made myself sick… and I loved it, every single second, especially getting on the scales.

I felt safe in my habits, I would lose weight, I’d get pretty, I’d finally fit in with my friendship group, and best of all I’d never be caught. Because no one expects the fat girl to have an eating disorder.

It became a daily occurrence, multiple times a day for as long as it took for my mum to forget about the self harm and weaken her guard so I could pick it up again. When I could start self harming again the food stuff became less intense.

It was always there.

Always.

But the vomiting emerged and disappeared again like the moles in the old arcade games of whac-a-mole.

The dieting came and went.

My weight yo yod. I could go from obese to normal weight and back again in a couple of months. I was good at losing weight. I was good at putting it on.

I learnt the calories in everything, I learnt every pro-mia and pro-ana trick in the book. I could sit for hours and tell you the easiest and most effective methods. The film ‘to the bone’ (which is probably one of the most accurate ED films I’ve ever seen) describes this as ‘calorie Aspergers.’ Although I don’t appreciate the analogy fully, I get where this is coming from. It’s an obsession, an addiction, it’s time consuming and all consuming.

I spent years like this, and they came and went pretty quickly when I look back on it. Sometimes eating disorders are made to look glamorous but the very real side effects meant that –

I started to lose my hair.

My teeth started to rot to the point they would just break in half and fall out.

My nails were yellow.

I was always shivering.

I missed social events that involved food or drinks because of fear of calories.

I failed a subject at school because I was to scared to get up and get some more paper because I thought I would draw attention to how ugly I was.

I refused to leave the house, I firmly believed I was so ugly if someone saw me in the street it might make them sick.

I found a new thing, chewing food and spitting it out, all the taste, non of the calories.

Then I went to university. The freedom only made my habits worse until by the end of first year I was spending so much on binge food I was getting myself in debt, I was throwing up over 5 times a day. Some days I felt like that wasn’t enough so I would take 40 laxatives as well. I even started smoking because I read it was an appetite suppressant.

One night, like many others, I passed out on my bathroom floor. When I came round again I had the realisation that I was literally flushing money down the toilet.

The next day I registered for a doctor and made an appointment, I was referred to the ED department of the local mental health services (after being told, really helpfully, that I shouldn’t get my hopes up for treatment because they only treat ‘proper eating disorders’).

A few months later I sat infront of a doctor. He told me he’d read my notes and asked me what I thought the problem was.

I told him I didn’t know.

He told me that was a lie, that I was a smart girl and I knew myself that I was bulimic.

He told me we would break for lunch, he said I could stay in the room if I didn’t want to eat and he would bring me some water.

He recommended me for treatment and put me on meds to stop my oesophagus rupturing and sent me on my way.

He got it. He didn’t tell me I was to fat to be Ill. He didn’t tell me I was making it up. He told me it was real, I wasn’t on my own and I was going to get treatment. After the session I went to the shop, I bought food for dinner and I ate it, and I didn’t get rid of it.

I had a mixed experience in treatment, in the end I gave up going because it was setting me back but it didn’t make the treatment itself wrong, in fact the skills and thing I learned set me well on the way to recovery.

For a while food wasn’t an issue anymore.

But like any addiction that’s not dealt with properly it was always in the back of my mind. My mood cycles change regularly and you can guarantee that each one changes my relationship with food. My disordered food behaviours are always the first coping mechanism to reappear and the last ones to leave.

I catch myself with different thought patterns depending on my mood.

When everything so stable I get healthier, I eat better and I exercise more and I find myself losing weight in a healthy way. Weight loss is always in my mind. But when I’m stable in my mood I think about it logically, I am overweight, that is physically unhealthy and needs to change. To do that I need to eat better and exercise. I can talk about weight loss, tell you that I am comfortable in my appearance but need to lose weight for my physical health and be confident that I believe this.

When my mood is low I catch my own bad though patterns and behaviour but I’m never willing to change it. I have an underlying belief that my weight is what makes me unhappy, so when my mood sucks I believe that I’d be completely happy all the time if I was thin. So I start the quest.

Firstly, I stop eating and drinking. A few days in to that I’ll start to feel ill from dehydration so I’ll drink. Then I’ll feel like I’ve messed everything up so why stop there? I’ll eat again. Immediately after I eat I’ll feel like a failure, get rid of the food by any means possible and finally feel empty again. Feeling empty gives me a buzz, getting on the scales everyday to see the weight coming off gives me even more of a buzz. Then the cycle will begin again and will last until my mood changes, and then a bit longer while I work on breaking the cycle I create.

When my mood goes up, I’m awake for days, I shop for clothes even more than normal and I work on smashing calorie and weight loss targets. I get weighed everyday and depending on what the scales say set my calories for the day, anything between fasting and 1,800 calories. I burn off what I’ve eaten because of the boost in energy that comes with hyper mania. When I’m in that state I’m always successful and nothing can stop me. I get the buzz from going down clothes sizes.

I have come to accept that although generally if my mood is stable food isn’t a big issue for me anymore, it will always be an area I relapse into. I will never have a normal relationship with food, and to be honest I don’t even know what that would look like for me. Now it’s about controlling the patterns, maybe my next relapse will only last for a couple of weeks rather than a couple of months. Maybe I can pick up warning signs quicker than normal.

A stable mood means more stable thinking, I can identify the things that trigger my behaviours and I can avoid them. I can stop conversations that will set me back. I can stay motivated by health rather than a desperation to have a thigh gap.

But nobody is permanently stable, whether it’s mental health related or not there are always Highs and lows, and for me there will always be food based behaviours that go along side that.

While I was in treatment I was given a list of what normal food behaviours were, it was explained to me that I just take them to extremes.

It is normal to eat junk food or overeat on a bad day. It is not normal for that to mean repeatedly binging and feeling guilty about it.

It is normal to not eat as much if you’re stressed or agitated or even just busy. It is not normal to stop eating for a week because your preoccupied.

It is normal to cut out certain foods to try and get healthy. It is not normal to cut out all food.

Being diagnosed with bulimia and BPD has made me realise how most of my issues come from living in the extremes and struggling to find a middle ground. I rarely focus myself on eating disorder recovery, what I need to focus on is living in the middle and not the extremes. In BPD talk we use the terms black and white and grey. It is natural for me to live in the black and white, I need to live in the grey. We also call it ‘splitting’ or ‘split thinking’ which are terms I identify with all to well. I strongly think that when I get to grey, if I ever can get to the grey, most of my issues will fall in place. I think my issues with food aren’t issues with food, they are issues from the mentality I carry in most areas of my life, they are issues that don’t belong in the grey.

What it feels like to be signed off work for mental health reasons.

I have been declared unfit for work due to my mental health numerous times. Sometimes I would be signed off, go back to work and be signed off again after one shift. That was in my last job, a job I enjoyed but didn’t really care about. It meant nothing to me to miss a few weeks or months and then go back. Around 18 months ago, after just graduating university and after a crazy (quite literally) year I landed a new job. A job that I cared and still care about. In those 18 months I have phoned in sick twice, only one of those times was mental health related and it was just after my dad passed away so I kind of let myself off for that, and, even then it was only a couple of days, not long enough that I could no longer self certify.

A few months ago, maybe more than that my mood took a turn for the unstable, I was carrying on as normal and keeping myself on track enough to still be working. Then I wasn’t. In mental health world theres a fine line between struggling and in control and struggling and no longer in control. Right now, I find myself in the latter part. I may be in control of my actions but I am completely out of control on an emotional stability level. It started to effect me at work and a few weeks later I found myself declared unfit. It hit me hard, I didn’t ever expect to be back in that place again. Lets talk about the issues and the positives that come with being signed off shall we?

So, before I get into the issues, here are the positives that I can think off.

• Being signed off gives me more faith that my doctors know my illness. They know when its time to say stop and time to say go. My doctor advised I be signed off a few weeks before I was, he left it with me and I was adament I wouldn’t do it, but on my next visit and the worsening of my symptoms he took the option out of my hands. Looking at the situation that was the right call, and that helps me trust the system a little more.
• Being signed off takes some of the pressure out of day to day life. For now I don’t need to think about going to work and functioning on that level. I have time to focus on keeping myself safe and that can be full time job in itself.
• I have the time to work out an updated plan for keeping myself well. The last one I did was a couple of years ago and included things such as ‘go out of the house at least once a day’ and ‘make sure you at least shower.’ Those things are no longer an issue for me now I can swap them out for skills that help me in my higher functioning lifestyle. In looking at those plans I can also appreciate how far I’ve come, and praise myself for it. Like, at one point I was that unwell I couldn’t function without hospital stays and friends monitoring me and actually one hard time in 18 months is fucking good going. Recovery is never a straight line.

Now lets talk about the challenges, and to do that lets start at the beginning of the being signed off process.

Firstly is the visit to the doctors, I don’t have a massive issue with this, I’ve always trusted my doctor, more than mental health professionals in some cases, but it can be daunting for some people to go to there GP and tell them there mental health issues.

The next thing is one which I struggle with, the dreaded phone call to work. Like hey, I know I’m meant to be on shift tomorrow, I know I’m screwing you over massively and someones going to have to work extra hours but I can’t come in tomorrow, or for the next 3 weeks. I had so much anxiety over doing it, and it makes me feel like the biggest dick on the planet, but truth is it’s better that I do that than come in in the non functioning state I’ve found myself in ( I should also add that if you have a good employer there shouldn’t be 20 questions or any guilt led by them, luckily for me I am in that position). Currently Ive been signed off for a week longer than expected with a note on my sick note saying I need to be reassessed at the end of the two weeks. That scares me even more, because once again in 2 weeks time I may have to ring in again saying I’m not going to be back in at the last minute, leaving me with the, you’ve just screwed everyone over once again feeling.

Then theres the ‘I feel emotionally naked’ feeling, I am open about my mental health but theres something really degrading to me (and I’ll admit its my issue) to hand in a sick note that discloses my biggest secret, the thing I try hardest to hide.

An issue I faced today was the wording of my sick note, which just says ‘depression’ when I actually want to explain. Yes depression is an issue for me, but right now its instability which means depression, hypermania, impulsivity, anxiety, inability to function in relationships, flashbacks, addiction,dissasociation and so much more. My doctor always puts the least possible on my sick notes because of confidentiality but sometimes it feels more of a hinderance than a help.

Then theres the actual time off. 

How do I explain to the people around me that Im not working for the next couple of weeks? To my mum (who I now live with) I’ve gone down the line of stress. Theres a lot the older generation don’t understand about mental health, my mum falls into that category, which I don’t blame her for at all. She actually tries really hard to understand and support me but I can see the panic and confusion when she tries to talk about it, I think thats a problem with the education in mental health rather than her, but still its there. So for now I’ve gone with stress, then theres the rest of the family, they understand a lot more, but do I change my story to them and risk exposing myself to my mum?

What am I meant to do with my time?

Theres something about being crazy that turns you into a child, like have a spent the last week doing jigsaws and puzzle books just to keep myself distracted? Yes. Have I being spending 18 hours in bed? Yes. Have I been painting and colouring? Yes. There is another panic, what if when I get back to work someone asks me what I’ve been doing? When I answer it won’t sound like I’ve been ill, it will sound like I’ve had a bit of a jolly, but actually I’ve being doing those things to distract myself from my own thoughts and pain.

I 100% don’t want people to know that I’ve spent the first week of my time off reliving every moment of my last 2 weeks at work questioning every decision I’ve made whilst at work. Like have I fucked everything up. When I said that, was that me or my mental illness. When I snapped at that co-worker, was it justified or was that my illness. Then theres the bits I don’t need to overthink, I know I fucked up because of my mental health and I feel guilty 97.34% of the time.

Being off work means any small amount of motivation I had to keep it together has gone. Like, do I want to start drinking as soon as I wake up? fuck it theres nothing to stop me now, do I want to stay in bed all day? Yes and now theres nothing to make me get up… I was going to make more examples but I’ve reconsidered in case they disclose to much, sorry about that I guess. Truth is in the job I work, it would be selfish of me to carry on going in, barely aware of reality just to keep myself going.

And lastly, you’ll be glad to hear, heres my massive concern, what will people do when I get back? Will everyone treat me like normal and pretend I was never off? I hope so. Will people ask me if I’m Ok? please no, because lets be real, I’ll be better, I’ll be functioning and I’ll be back to doing my job, hopefully well. Will I be OK? probably not, just better.  Worst off all, will people question my ability to do my job? Will I be seen as less? Will my time off be judged? With everything I’m hoping the answer is no. But thats part of the issue with mental illness isn’t it? If I was signed off sick because of a stomach bug, or the flu, would I have the same issues, the same questions?