Anonymity at A&E

[CyanCloud]

Hi

I know this is a bit of a weird question, and I've namechanged to ask it because I'm paranoid.

Does anyone know if you can remain anonymous if you go to A&E? I mean, will they treat you if you don't want to tell them your name? I've tried googling, but nothing definitive is coming up.

Thanks all.

Why not do some research and find out where nearest minor injuries unit is. Often not in city hospitals but often in smaller cottage style hospitals or in smaller towns. Or even in walk in centres. May be less frightening for you as they do not have approved social workers or mental health teams available as they do at a&e departments and they can do stitches etc.

That may give you a more positive attitude towards professionals and be a small step forwards for you.

What activities do you to that helps you feel more valued and have self worth? You do not have to see mental health professionals for that. Fr instance I have just started a yoga class to give me sme me time, because I can get value from spending time on me, doing something for me. It's all little steps and does not have to start with gp's if that is not where you are at. Finding a friend to confide in is a route for others.

I've had a look, and found an MIU relatively near me. Only open until 8pm, so wouldn't have been useful last night, but at least I know it's there for the future, should I ever get the nerve to visit.

I don't really know what things I would do to feel valued. I don't get any real enjoyment from anything, so I seem to spend a lot of my time just either killing time, or doing things because I know I should.
I don't have any friends. I don't mean that melodramatically, and it's not something I really think about. I don't want friends/relationships, I can't deal with that level of closeness, and how much pressure is involved.

I really struggle with how fake things are, and as much as I force myself to do things, they never change. I was working by "fake it till you make it", in the hope that I'd gradually start to enjoy what I was doing, but it's never happened. I think it's just because I'm boring.

In my experience A and E are very demanding about details and the forms to fill out, because of so many people who aren't entitled getting the treatment. A minor injuries centre seems like a better idea if it comes up again.

I'm very sorry for you Cyancloud. It is one of the greatest achievements on this great good earth to be content with yourself. It sounds like you're discontented with yourself because you don't want to do what other people want to do, and don't really want to do what you think you ought to be doing. Too often we feel we should be this, or should be that, or the other, and then we measure ourselves up to a standard or to other people's standards and find ourselves wanting. Nobody should do this. I'm sure you don't need to; you aren't boring, you're articulate, and sound self-contained, and shouldn't feel the need to fake things, and it's a shame that you do. It's quite enough in life to be quiet and not be a bad person and to be kind. Lots of people (me included) go to social occasions when we'd rather be, I don't know, watching an old Morse video in our pjs or going for a walk or to the library and it wastes such a lot of time to do things "one ought" instead of what would be nicest for you. Good luck dear.

I didn't want to read this & not post. I don't really have any advice, other than to be sure you get medical help for the wound. I have had similar problems & get very panicky about what will happen & how much I should/ shouldn't say.

MN is a good place to talk, if you need to. People are always here & will listen.

Please look after yourself.

Thank you both (and all).

It was a therapist I saw once (a couple of years ago) who told me to 'fake it till I make it', the idea being that I was doing enjoyable activities, I just wasn't open to actually enjoying them. It has yet to work, and I find it exhausting to keep doing said activities (and I'm not talking anything strenuous; exercise, TV, reading, films) with the constant pressure to enjoy them. I have very little energy, and I need to spend it constructively instead of forcing myself to read a book and lie to myself that I'm interested and enjoying it.

The SH will be fine; it's clean, with no signs of infection, and I've changed the dressing without interfering with it.

I've long since accepted suicide as an inevitability. It's constantly on my mind, and is only ever something that I'm 'putting off', rather than eradicating as an option. I know it will sound strange and morbid to a lot of people, but having it as an accepted option is such a relief at times. Life itself seems fake, and hollow, partly because I know how it's going to end up. I don't feel sad about it. I don't think I'm entirely real. The best way I can describe it, is as though I'm a character in a game and I'm going through the motions. (Please someone say if saying this is inappropriate and I'll report).

Sorry if this doesn't make sense, I'm going to post before I delete.

Oh you poor thing. This is terrible. The faking it doesn't seem to work at all. Do you like anything? Do you like being on your own in a nice clean house and reading a book, little things like that? Do you like things that other people think are boring so you feel you aren't allowed to like them?

"Life itself seems fake, and hollow, partly because I know how it's going to end up."

This is a very intense way of expressing your feelings but I accept that this is how you feel right now. Are you able to explore how much you have felt this way before? Sometimes when we are very unhappy we feel unable to imagine that we have ever felt differently but critical reflection means that we can identify times when we have felt differently. If that is the case for you then maybe there is a possibly different future available which involves working on finding out what links those times when you have found life more meaningful.

"I don't think I'm entirely real. The best way I can describe it, is as though I'm a character in a game and I'm going through the motions."
This is very common to people who are profoundly unhappy. It is called depersonalisation. If you talk to any trained mental health professional from a psychiatric nurse to a psychiatrist they will recognise it. It is a terrible experience though and some people who self-harm say they need to do it to keep the depersonalisation under control and remind themselves that they are real.

Honestly, I think you have severe depression and only a really skilled psychiatrist will be able to assess you and help to put together a treatment package that will address your unhappiness and your self-harm which might include more meds and more talking therapies and you will need to talk frankly about why you feel these things did not help enough before. You can either see your current GP again or try registering with a different practice to access specialist mental health services. Going to A&E for help if you feel the need to self-harm would be another route. But be aware that no GP can diagnose a mental illness if you don't tell them about all of the symptoms you are experiencing. Which will be really hard.

As for what you are worth, you are worth as much as me, or my beautiful daughter whom I love most in the world, or anyone else. No one has more or less claim than you to be helped.

There are a few TV shows that I like (all, annoyingly, are between seasons at the moment), and films. I have a short attention span, and struggle with books because I end up forgetting what's happened. I watch films in stages, because my mind wanders if I'm just watching a film for more than half an hour or so.
I do like for things to be clean, but it's not so much than I like the cleanliness, more that I hate things being dirty. So, I clean, not to achieve a state where I am happy, but to get rid of a state where I'm panicked and obsessive.
I can't really think of anything else that I like. That sounds ridiculous, like I don't know my own mind.

It was years ago that I accepted that suicide was inevitable. I've had periods where I'm desperate to die, and so attempt to do so, and periods where it's just "there"; a constant thought, but not acted upon. I know it sounds bad to other people, but it doesn't really elicit any emotion from me anymore.

I don't know if I'm depressed. I'm able to get out of bed, I very rarely cry (usually only at those awful pdsa-type adverts or similar) and I don't feel very sad all the time. I hate myself, but that's not because of an illness, that's because of the person I am.
I know it sounds utterly pathetic, but I can't do a talking therapy. I just can't. It's so triggering, and I get so anxious, I end up worse than when I started. I don't have anything to talk about, other than to whinge about current feelings which isn't going to do anything. When I saw my last therapist, I was overdosing the night before each session in the hope that I'd die and wouldn't have to go.

Thank you both for being so kind. I know that I'm being obstructive when you're giving good advice, and it's not intentional. I never really intended for this thread to go this far when I started it. I'm very grateful, but I'm wasting everyone's time when I'm not able to act on the advice that's given.

You are not being obstructive CC, you are telling us how you feel. We asked. You are not wasting anyone's time. We can just log off if we are not interested!

I'm a bit alarmed to read of your suicidal feelings and attempts tbh. I really think you need urgent help. Do you know, even if you just printed this thread out and took it to your GP, or sent them an email link, it would probably get the ball rolling for you.

I can now see why talking therapies would be worse than useless for you. You need much more skilled specialist help.

It's not obstructive, you feel the way you feel, and that's the way you feel. I don't think you should hate yourself - you're not a hateful person are you. You're not a bad person or an unkind person or a wicked person. Have you ever read even just on this site the hundred thousand small ways some people make other people's lives a misery? That's not you. Feeling inadequate because you aren't the way you think you should be is not a reason for hating yourself and it's not even a reason for feeling inadequate. Most people are caught up in themselves. I'm a bit worried because you sound so, so sad and I'm not qualified to be giving any kind of advice. However I'm now going to give my favourite kind of advice, and you are of course totally free to "reject" or pshaw it! It's about vitamins. I don't mean like, St John's wort or something herbal like that, I mean folic acid, zinc and B6. Zinc can help with concentration, B6 can help with a general feeling of energy and folic acid, I think that's just all round wonderful. They might make you feel a tiny bit better. It's just, doctors and therapists don't normally think about vitamins when someone is very down, and I think they're pretty marvellous. You sound nice, and I'm sorry everything feels so rotten for you.

Thank you both. I always feel like I need to apologise to people when they speak to me for any prolonged length of time.

I can't tell anyone about the suicidal thoughts/attempts, definitely not my GP. I can't talk about it. I really don't think that they're symptomatic of an illness. Talking about them doesn't make them go away, medication doesn't make them go away. Every time I've tried to access help in the past, it's been therapy/counselling, and it doesn't do anything but make me feel worse.

I don't know if you need to do anything wicked to be hateful. It would be arrogant in the extreme for me to like myself, when there's nothing about me that's actually likeable. Please don't take that as me asking you to list likeable adjectives, it's not a fishing attempt.

I definitely wouldn't reject anyone's advice, though I understand why it looks that way. I already take a multivitamin every day, just had a look at the box and it says that it contains at least 100% RDA of B6, Folic Acid and Zinc.

There's absolutely no need for anyone to be worried about me, I feel horribly guilty about that. I know you can't tell people what to worry about, but please don't.

I think not wanting to talk about this is a very valid response. What you are describing sounds very overwhelming even when written down. If I try to imagine what it might feel like to talk about those feelings to someone who might not understand me I imagine feeling quite terrified. At the moment you know you are isolated, and you feel unreal and worthless but that is OK because you have found strategies for handling those emotions and can therefore cope with them. If you try and explain these emotions to anyone else you run the risk of having to experience them all over again in a setting which is not safe, and where you may have to suffer acute emotional pain and there is no guarantee that you will feel safer and suffer less pain at the end.

And you have already experienced not being understood when you have tried to explain this situation to people so it is not irrational to expect that people will not understand you if you try again.

Conversely there is no way to get beyond the place you are currently that does not involve taking that risk of talking to someone and possibly experiencing some pain. So the trick will be working out how to make that risk as small as possible. Talking here. Or anywhere else where you feel safe and can just articulate what is happening with no one expecting you to actually do or be anything other than you are may help. The Samaritans and various online self-harm support organisations might be able to help you too.

If you want to keep saying what is happening and how you are feeling so we can trying to help you find ways to move forward beyond this point then please do. But you don't owe anyone here anything and you do not need to feel guilty if you do not want to talk.

PenelopePipPop, your first paragraph is exactly it. I've tried explaining it (though not nearly as articulately as you just did) and MH professionals don't seem to get it. They talk about how I have to "trust" them, but I don't. No-one just instinctively trusts other people, realistically. It has to be earned. I've never spent long enough with one professional to know whether I can actually trust them, the longest I've seen one person for is about 6 months.

I've used online SH sites before. I used to post on a forum on one of them, but stopped because it was too triggering and I started feeling uncomfortable/unwanted/paranoid. I know it would make sense to try again, but I've found those places to be very full-on. I've emailed the Samaritans in the past as well, though I didn't find that useful, as they just seemed to repeat my own words back to me.

I feel that continuing to talk is wasting everyone's time, because I know that I should tell someone medical in RL, but I can't. It's not just that it's difficult, or that I don't want to, I physically can't; the words stick in my throat and I freeze. I know I could write it down, but I know myself well enough to know that I'd never be able to hand it over. It feels too manipulative and attention-seeking to talk about how I feel when it's so negative.

You must be able to articulate something about your experience because I did understand you. I don't self-harm and I have worked in mental health services as an advocate but I'm not a mental health professional of any description.

So based on what you described one person could imagine a little bit of how you were feeling. Only a tiny bit and I don't think for a minute I know how to make you feel differently. But it was possible to make a connection in a place that felt safe. It is theoretically possible but hard.

I agree that trust is not automatic. I think though that the people who were telling you to trust them were expressing themselves very badly and did not literally mean that you should trust them. Even people who feel very confident and happy about life don't just trust people because they are told to, they trust people because they are confident those people will honour their trust and in life up to that point they have not been disappointed much which is lovely for them - a lot of people with mental health needs do not have that luxury. I think the people you spoke to really wanted you to behave as if you trusted them, open up and speak about your feelings even though that is hard and generally give them the opportunity to try and understand your situation. There is no conceivable way anyone, no matter how trustworthy, committed to you and skilled at helping you can actually help you unless you take that step. And it is the hardest step of all.

I think you write very well. If you printed off your posts on this thread and wrote to your GP explaining that you could not see her in person but would like a referral to the CMHT based on these feelings I am pretty certain she would act upon it (though she might want to try and talk to you too).

Would you like to try antidepressants? You could talk to your gp and say you have tried counselling in the past and do not want it right now, but would consider medication? Talking therapy is not for everyone and if you would not use it then it is not the right time for you. Sadly on the NHS talking therapy is rationed, so if you have it now and don't make use of it you cannot necessarily have it later when you might make use of it. Perhaps a time on medication would help you feel more able to make use of counselling.

I think OP has already been on meds Hoop.

CC it is precisely because your feelings and thoughts are so negative that they are so painful and harmful to you. And when you are in pain and suffering then you have the right to expect treatment. That is not manipulative or attention-seeking. It is just getting some help.

Lots of people fought for the NHS so that no one had to suffer in silence. Please, please feel that you, just as much as me, the Queen ... or anyone else, has the right to get help from the NHS

I think if you were referred to a really good specialist (who might not be local) then your experience of treatment might be very different to the one you had of talking therapy.

I know you don't think getting better and feeling happier is possible right now, but it really is. You won't always feel like this. It might be a long road but you will feel better eventually. Why not try and make that happen sooner?

I understand what you mean about professionals wanting me to act as if I trusted them, by speaking honestly. For me though, that would require actual trust, not just hoping for the best. I know that professionals tend to over-react (or perhaps it's just an appropriate reaction and I read it as being too much) when you mention suicide, so I've learned not to talk about it for fear of what they'll do.

I've been on a few different types of ADs in the past. None of them really did a great deal. Since the reason I came off them last time was because the GP said they weren't necessary, I can't ask her for them again, because she'll just say the same thing.

I don't know what kind of specialist I would need to see. I don't want to address the SH, at least not head-on. It's a symptom of how I feel, not the cause. I've never been offered anything other than talking therapies, so I think that may be all my CMHT does.

I can't help thinking that there is more being made of this than there should be. I'm genuinely not ill. I don't have an illness. It feels too overwhelming that you all seem to think that I do. I don't feel ok at all.

If illness is not the right way to understand this that is fine. Depression is just a word. A very commonly used word to describe people who feel intensely unhappy and hopeless and sometimes as if they are not real. That does not mean we have to call ourselves depressed when we feel this way or that feeling this way means we are ill.

What is true is that this is a terrible way to feel, and perhaps exhausting and frightening at times too. One way to try and address these feelings is to seek medical help. For most people most of the time this is the kind of help most likely to make a difference. But some people find solace in spiritual practices or simply in finding their own mode of living that helps them balance the fear and hopelessness with the things that they find comforting and sustaining. You have choices here. Personally reading your posts I would strongly recommend you try seeking medical help first because I think that is most likely to help you. But if it does not that does not mean there will not be other avenues to explore too.

"I don't feel ok at all."
That is what matters. You do not feel OK.

If you want to talk about your fears of what professionals might do if you talk about suicide please do. Is that a significant fear that is holding you back from talking about this? As before you only have to talk about what you are comfortable with.

I've tried some spiritual things before. I tried meditation, but I don't have the ability to turn my mind off. That 'empty, lack of thought' state is impossible, because I have too many intrusive thoughts that just force their way in there. I do yoga, but don't find it relaxing. I've read a lot about religion, but I lack any belief in a higher being, and as much as I try, I can't change that.

I know that the sensible thing to do is speak to my GP. I can't. I just can't. It would be too awful. I feel sick even thinking about it.

Re: fears around discussing suicide, I'm mostly scared of hospital admission. I know it's a last resort, and can be beneficial for a lot of people, but there is no way I would cope being surrounded by people everyday. I need to be alone, I have my little routines that get me through the day and I need to feel like I'm in control. I'm also scared of the crisis team, because I know they come to your house. Being forced to see people would make me incredibly anxious.

Thank you for talking to me so much, I know I'm frustrating.

I appreciate you find books hard to focus on but a book you might want to have a look at is A Book of Silence by Sarah Maitland. It isn't about depression, or spirituality and it definitely isn't a self-help book. It is just about a woman who realised she liked a quiet life. Really really quiet so she set about exploring how to achieve the quietest life she could and thinking about why silence and having space to reflect was so important to her. You can dip in and out of it, it shouldn't be triggering, it isn't about how to get better, it is just about how to be.

I found it quite comforting when I had a very short and intense episode of depression a year ago and like you needed not to talk sometimes to have space to recover. I don't think our situations are the same because it sounds like you have been suffering for much longer than I did. But maybe you'll find thinking about space and silence helpful too.

The crisis team only come during crises which for you will mean if you are suicidal. I think if you are at that point then your deep unhappiness may well overwhelm your anxiety about letting people in (or at least you'll be so unhappy you won't be able to distinguish your anxiety from the overall awfulness of the situation). They will not judge or bully you. They will respect your space and your dignity and try and listen as carefully as they can to what you are saying. They may want you to come into hospital. They may not. And yes they can use legal powers to get you into hospital if you do not consent and I can understand why that is frightening. Most people who are detained in hospital under the Mental Health Act are admitted for less than 14 days in total. But those 14 days are tough.

Have you been in hospital before or visited friends in a psychiatric hospital? You are right of course, there would be people around and you cannot follow all of the routines that help you feel safe at home. But it isn't anything like a general hospital ward and nothing like you'll have seen on TV. You will be able to do your own activities during the day, you can spend time alone if you need to and if you are not detained under the Mental Health Act (and the vast majority of patients are not) then you can leave the ward.

Going into hospital isn't necessary or a good idea for you. It scares you and I cannot imagine it would help you. It would only arise if a healthcare professional was concerned that you were at a serious risk of harming yourself and were not going to access appropriate treatment at home. In your case that is unlikely, for example you have already taken anti-depressants in the past and you only stopped because your GP stopped prescribing them. It would be wrong for me to say it could never happen but in my experience a very very large proportion of people with mental health needs (not just depression) talk about suicide, only a small proportion need treatment in hospital and only a small proportion of those are detained patients who are there against their will.

A good place to find more information would be the Mind website which has lots of information sheets about rights and access to services.

I do not find you frustrating.

I'll have a look for that book, thank you. I'd love to be one of those people who is sociable and outgoing and likes parties, but I'm just not. Never have been, and however much I've tried to force it, it's always been very anxiety-provoking and ultimately makes me feel lonely. I just can't cope with other people.

I don't know if I would want to be stopped/helped when I'm actively suicidal. I've never once sought medical attention/tried to access help when I've attempted suicide before.
It's hard to explain the difference between the two suicidal states. Most of the time, it's just thinking about it, and I would be quite happy to die, but I don't feel like I have to act on it. The rest of the time, I need to make some kind of attempt, I desperately want to die and wouldn't be able to be honest about how I was feeling in case I was stopped.

I know that if I told professionals about the first 'state', it would probably be ok. The second state though, would probably be classed as me being at risk, and that's where I get worried. I know as well, that if I told them about the first state, they would be inclined to ask about suicide attempts and I don't think I could lie about them. There have been quite a few, some very recent.

The other thing that makes me think that professionals might class me as being at risk, is because I overdose quite regularly as a form of SH. They're not large enough to be classed as a suicide attempt, nor is there suicidal intent behind them. It's just an alternative form of SH. I've never told anyone, never sought medical attention but I know how it would sound to an MH person.

I can't see that any good would come from disclosing any of that to anyone IRL. At most, they'd prevent me from suicide attempts/ODs, but that's not going to change anything.

I have known people who have been detained on psychiatric wards. None of them have ever spoken positively about the experience, and one of them went on to successfully kill herself afterwards. I've never actually visited one though.

I don't know if half of that has made sense. I feel triggered and anxious, and I don't want to re-read it. Sorry if it's a babble. I've bookmarked the Mind site and will have a look soon but I can't focus at the minute. I find myself incredibly frustrating but thank you for saying that you don't, and thank you so much for being so understanding.

Just to reassure you that hospital is a real last resort. Partly due to lack if beds and the fact that resources are so limited. Honestly they do everything to keep people out of hospital, even if one is suicidal or attempts suicide they are not necessarily kept in a psych hospital. Most hospitals do not have talking therapies or help available, it is a place of safety etc.

I have talked of suicide many times and not been admitted. You say CMHT teams only offer talking therapies. They can offer occupational therapists, social workers and nurses to support people. Talking therapies are rarely long, long term so it is hard to trust in time limited circumstances and often why talking therapy is not always offered until someone can make use of it. There are group therapies, some places do art therapy or life skill groups. Medication can be discussed and monitored.

Alternatively have you looked into any charities in your area offering support such as mind or rethink or other local org's? Websites like livinglifetothefull or mood gym can be a use perhaps?

I didn't mean that all CMHT's only offer talking therapy, but I think mine might, because it's all I've ever been offered. I can think of a handful of (probably paranoid) reasons why they might let me think that. I've seen a CPN for assessments before, but they've always recommended talking therapies, which I try to do, and inevitably fail at. I appreciate this is my fault for being unable to tell them everything, and then just being crap at talking about anything. Actually, I appreciate that the whole thing is my fault, and I need to suck it up and get on with it.

I tried doing the moodgym CBT thing, but didn't really understand it. It didn't make any sense to me, just felt totally patronising and fake.

I don't know about any charities. I think there are probably offices in the nearest city, but I can't get there. I'll have a look at Mind/Rethink and see what they do.

I think talking therapy is often better than a Cpn. My Cpn just supervises medication, compliance and risk assessment, no talking or support!! Do you have a diagnosis, as often much depends on what diagnosis is as to what offered by CMHT's. would it help to see a psychiatrist as your gp can refer you to one?