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.

I'm not ill. Had diagnoses in the past but now I'm not ill. GP wouldn't have stopped my last lot of meds if she thought I was ill, so I take that to mean that diagnoses are now null and void.

I definitely don't need to see a psychiatrist.

A psychiatrist can help people who struggle with self harm, that was the only reason I suggest it. Sorry.

CyanCloud I have been keeping up with this since you originally posted.

I would agree that you are not unwell in the way the medical model considers being unwell, but I do think you have mental health problems that can be tackled.

Talking therapy covers a huge range of things really, from day to day coping skills to dealing with the reasons you feel as you do. I have seen a psychologist at my CMHT and I currently see my CPN. She does do therapy with me, I am doing something called Compassionate Mind at the moment which helps. I find that CMHT have a more longer term, recovery based approach, you are not limited to the prescribed 6 weeks sessions that your GP service might offer. My CPN helps me to look at both longer term and short term stuff, we look at my immediate risk and at the stuff that will make my life better forever.

The crisis team will see you away from home, they have offered to meet me in cafes before. Hospital is a last resort, and one rarely considered for people who are not psychotic.

Some of the things you talk about make me wonder about whether you have some elements of borderline personality disorder. The sense of not feeling worthy, self harm and suicidal thoughts. I am not saying you have it, but it might be worth exploring this sort of area. I can relate to some of these feelings, and I can certainly relate to the self harming (including overdosing) and I have a BPD diagnosis.

Reading your thoughts about feeling you have failed at talking therapies make me wonder if you explored that within your therapy. It can be useful to examine or discuss feeling unable to be honest in therapy. Part of therapy is the relationship with the person you speak to and part of the work can be around building and developing this. It is not your fault that you find it hard, it is normal and human to find talking about personal issues hard. Sometimes I go and see my CPN and don't talk about anything and sometimes I go and we have twenty minutes of great discussion.

I have generally found attitudes in A&E and in MH services to be really good about SI, generally people accept it is a coping strategy and accept when you don't feel ready to stop. I think they can struggle to understand that an OD is SI, but equally I have been believed when I say it is not a suicide attempt and that has been respected. I always refuse to see the crisis team at A&E, it is respected. I rarely discuss my MH issues with doctors or nurses and it is respected. They value me being safe and looked after over pushing me into situations which make me uncomfortable and might stop me attending for treatment.

I don't agree with your idea that being taken off medication doesn't mean you have any problems. If you read the guidelines for BPD it actually states that medication is not necessary.

This is long and rambling. Take care of yourself.

Sorry, I didn't mean to be rude, I can't focus and my head is too full. I just don't need to see a psychiatrist because I'm not ill. Seen two in the past anyway and they never actually did anything except take notes of what I said, then write contradictory letters.

Not long and rambling at all, fluffy, thank you.

Re: the crisis team. I can't go to places like cafes because I get too panicky, but am sure there'd be a middle ground if they were happy not to come to the house.

I don't know anything about borderline personality disorder. I would say that it should have been picked up on, but since I'm never entirely honest, it probably wouldn't have been.

I've never discussed being bad at therapy in therapy. I didn't even know you could. I've always had a few sessions, then the therapist's said it's obviously not helping because I can't talk about anything, and ended it.

I would never seek medical attention after an OD, not least of all because I wouldn't physically be able to walk to the hospital after one.

I feel really bad that I'm not giving your post the kind of reply it deserves. I can't think properly at the minute. I can't describe it without being melodramatic and pathetic.

Thank you all for talking to me (and sorry for the double post).

Yes, there is a middle ground :) Basically, they will find places that are acceptable for you. They do come to my house but that is my choice because I feel safe and comfortable here.

You can talk to therapists about your feelings about it. I often talk to my CPN about my relationship with her and my worries and fears about my treatment. Some of the work they can do is about helping you to engage with them and helping you to open up. The MIND website has useful information about BPD and it might be worth a read when you feel ready.

No overdose is safe, and the effects can be cumulative, so lots of small overdoses can be the same as one big one. I found out this year that I have liver damage from my previous overdoses, it is a hard thing to deal with. I did it as SI but it is hard that stuff I did a while ago still affects me once the immediate SI feelings/wishes have passed. I know you are worried and I know nothing I say (type) will make a difference but it is important you seek medical support after an overdose, it can kill you. I know this sounds a bit daft but I always think about how I would feel if I my SI went wrong. Oh gosh, I hope this isn't too morbid!

I am not trying to make this about me, but I guess I am reading this with my own experiences. I suppose for me, it got to a point where not being honest and trying to manage things myself got harder and harder until I couldn't. And sometimes I wish I had had the help before it got to this point because I could have.

Your posts about your thinking feeling muddled and difficult really resonate with me, you can have support to work through this so things feel less difficult. So SI and suicide feel less inevitable.

I completely agree with Hoophopes the chances of you being admitted to hospital are tiny, especially if it is something you actively want to avoid. And I appreciate that if people you have known have had bad experiences then it is rational to want to avoid it.

A psychiatrist might help to work out what links your underlying experiences of sadness, anxiety, a need to self-harm and feeling suicidal together. That might be depression or it might be BPD or it might be something else. A psychiatrist would also want to explore what caused you to feel this way since most people do not and you have clearly felt this way for a long time. Understanding that better might make it easier to work out what kind of therapeutic intervention would help you most. It is true that the only ways mental health professionals can really help are by giving them medications that either make their emotions more stable (less anxious maybe) or make them feel slightly happier or by talking to them. But not all meds are the same and how therapists talk to people, what they talk about and why and for how long will all be dictated by understanding why the person is so unhappy in the first place. For which you really a need to see a psychiatrist or possibly a clinical psychologist.

I appreciate you have had conflicting psychiatric assessments in the past. It is not an exact science because working out what is happening inside someone else's mind is really really hard. For the same reasons it is bloody hard work being a mental health patient and the best mental health professionals should know and respect that . But fluffydressinggown's experience at A&E and of the crisis team has been that there are professionals who get this. I think self-harm is an area where understanding has leapt forward a lot in the last ten years and as fluffy says a lot of people in healthcare (not all) now understand the importance of selfharm to some people as a coping mechanism and even that an overdose can be a form of self harm.

On this thread you have apologised a lot for wasting time or being frustrating (you do not need to do this). You are obviously very very conscious of how your behaviour affects other people. Is it possible you are over-estimating the extent to which you are imposing on others and under-estimating the extent to which others want to help you? And might this be affecting the decisions you make about getting help when you are injured?

Hello Cyan Cloud - just a hello and a wish you well really. I have got nothing to add to advice/words already given by others but just to say, hope things work out - very trite but it's a good luck from here.

Fluffy - I'm sorry you have liver damage. I know about the cumulative effect of overdoses, but recently had a liver function done (as part of a blood test for something else) and it came back fine. I don't think it's morbid to think of what would happen were SH to go wrong, I do the same thing. I always secretly hope that these ODs will be fatal. It would be a relief.

I don't think you're making anything about you either. It's natural to relate things to your own experiences and it helps to know that other people understand and can empathise (even though obviously I'm not glad that others feel this way too).

Penelope - I know I need to try again with the professionals. It's logical that, although I've tried quite a few meds, there are others I haven't tried. It's logical that there are different therapeutic approaches that I could try, and obviously different therapists. However, knowing this doesn't change how anxious I feel (because anxiety is illogical), nor does it change how I feel about myself. It's almost cyclical; I need to feel better about myself in order to feel like I deserve help, but I need help to feel better about myself.

I don't think that I'm over-estimating the amount I'm imposing, but it is possible that I'm under-estimating how much people want to help others. I know that there are people within the medical profession who have a genuine desire to help people (though I also know there are those who do not and who are just there for the paycheck). I struggle to apply that knowledge to me, because I don't feel like a proper person.

Crumbled - Thank you for the good wishes.

I'm very grateful to how much time and support people have given me, but I think I need to stop posting. I had a really bad night, and I think that feeling vulnerable over talking about these things contributed. It's doesn't feel safe having it all 'out there', even only online. I don't feel entirely in control when I talk about how I feel, so I SH more.
Thank you all very much for all the help. I'm sorry to have taken up people's time.

"I need to feel better about myself in order to feel like I deserve help, but I need help to feel better about myself."

and

"I know that there are people within the medical profession who have a genuine desire to help people...I struggle to apply that knowledge to me, because I don't feel like a proper person."

Those are really insightful statements. I know they do not make your situation easier but you have started to frame your situation slightly differently. At the start of this thread you made a lot of statements about how you were a hateful person. Now you are describing why talking to anyone about how you feel is so difficult much more clearly and not calling yourself hateful.

That is actually a big step forward. I'm going to hazard a guess that doing that and not just describing yourself in terrible and absolute terms as worthless and hateful was exhausting and really challenging and that is why you felt the need to self-harm too.

That is not a failure.

I can appreciate that this is really hard for you and that you now want to end this conversation. That is fine.

I still have time.

So I wasn't going to update this, but I thought; why not.

I saw a GP today. Not my usual one, this was a locum. She was nice; friendly and she listened quite well. I tried to kill myself a few days ago, and I told her this. I told her that my level of anxiety was becoming intolerable; I can find pretty much anything to be anxious about, and my thoughts are obsessive. She was sympathetic, but ultimately, unhelpful.

She asked if I was currently suicidal. I was honest, and told her that suicide is always an option. I think about dying constantly, and it would be very welcome. I intend to kill myself, and will attempt it again soon. She, again, was sympathetic. Lots of "poor you" which is horrifically patronising and made me feel like a four year old who'd stubbed their toe.

She offered to refer me for counselling. I told her I've tried that before, and I can't cope with it again. I am empty, and there is nothing left to say.

She felt medication was not a good option right now. I agreed. It would be horribly selfish of me to manipulate anyone's time in the pharmacy, and a doctor's time in doing repeat prescriptions.

I left, feeling like an attention seeking child. I'd wasted her time, and I feel guilty for it. She was polite, attentive and professional. I was pathetic, whiny and useless. She praised me for seeking help (though scolded me for not seeking medical attention after the suicide attempt) and said how "brave" I was, and how I should always come back to "discuss my options". I don't know if she was intending to be kind, but it didn't feel like that. Perhaps my perceptions are twisted. I think not. She was trying to tell me to fuck off, and I obliged.

I am very tired, and I have had enough.

No real idea why I'm posting this, but re-hashing the appointment has been helpful in getting things straight and justified in my head. I intended for this to be helpful to others in a similar situation, but I don't think that is the case. Other people are real, useful, proper people and they deserve every ounce of help and love they can find. I have realised that I am not like them.

CyanCloud, you are so brave. Ten years ago, I was where you are now. Almost everything you have written could have been me. I never had the courage to speak to the doctor except one time. Then I realised I had made a huge mistake and spend an hour or so back-tracking until they agreed to let me leave. What did come out of it was that I was sent to see the local priest (I have a huge, pathological mistrust of medical staff and everyone else) for some counselling. This was the answer for me because I felt able to believe he wouldn't force me into any treatment I wasn't happy with because it was confidential and against his beliefs to speak about it I went to see him for 4 years and in the first three I didn't speak to him about anything beyond how my week had been. Eventually I felt able to answer some of his yes/no questions. He asked me once to go to the doctors, but he called and spoke to the doctor first and all I had to do was turn up and confirm my name. The only condition he put on me was that I had to tell him if I SH so he could decide if I needed medical treatment.

It gave me enough to be able to get on with my life, even without SH, for a while. Only now has it been suggested that I might have a personality disorder. What I'm trying to say is that it sounds to me like it would be more beneficial for you at the moment to have someone who could help you with day to day living rather than at the causes of what makes you feel like that. You cannot even begin to confront things unless you feel safe to do so and I'm only telling you about what my situation was like because maybe a medical environment isn't the best place for you to find that safe place at the moment. It is an awful place to be, I really feel for you.

Please don't stop posting. I'm going to use one of the lines my counsellor regularly used on me years ago: Stop being so arrogant. It is not up to you to tell me what to do with my time. It is MY time and if I decide to give it to you to, then that is MY choice, you are neither wasting it nor taking it up because it is MINE to do with as I wish.

I think your posts are very helpful actually. You said Other people are real, useful, proper people and they deserve every ounce of help and love they can find. I have realised that I am not like them. I know this statement must be wrong because I could have written it. Maybe most other people, or the majority of other people, but certainly not all other people as you seem to imply. No, you are not like the majority of other people. You are you. An individual, a person in your own right. And we would be very honoured to know that you are willing trust us enough to keep posting to us.

Hi CC

Hope you're coping ok at the minute.

I don't know any answers for you as it sounds like you haven't yet found the right professional to speak to which is a shame. It seems like your posts have developed since your first posting & you are obviously empathetic & kind to others people's situations & feels like you should keep posting. I promise you are worth what others are willing to give you.

Please keep posting if you feel able as some of the previous posters have provided some great advice & I think this thread will definitely be useful to others.

I wish I could do more to help but really hope you manage to make some headway & get to believe in your value as a person -you are obviously bright & logical & I don't think you are seeking attention-also remember though it's hard to know if your interpretation of the GP's attitude is accurate, although I think she should have left you with some options of further discussion/treatment.

Take care, Evelyn

Hello Cyan. I started to read your post as I was wondering what the answer was to your first question but see things have moved on since then. I am another one who believes that you are a worthwhile person.

Margarita's post is inspiring. You are right Cyan that it can be incredibly hard to trust and NHS talking therapies are not set up to allow seeing someone for a very long time. Yet we know, from years of research, that what can really make the difference is a trusting, continuous relationship (I don't mean a romantic relationship) and it seems like this is what Margarita's experience gave her. Someone to talk to, without an agenda other than being there, someone who did not have to report back to their funders about progress, someone who was familiar enough with death to not fear it if she did choose that path. We also know that for some people, talking is very stressful and writing or other forms of communication such as art are far more beneficial. I am wishing for you that you find someone who might be able to just be with you, communicating in whichever way feels right for you.

There was a thread running on here a while back, can't remember what it was called, where people who liked to spend quiet time alone posted. It was a great thread, as, people discovered they were not odd or so unusual, it's just that they hadn't realised so many other like minded people were out there.

Thank you all.

Margarita, I'm glad you found someone you were able to speak to. Your priest sounds like he was really helpful to you. I'm definitely not trying to be arrogant, and I'm pretty horrified that's how I appear. I know it's logical, since I'm talking solely about myself, and that in itself is an arrogant behaviour. If a counsellor had told me to stop being arrogant, I would have been mortified; I would have either completely stopped talking about myself, or stopped going to sessions.

Evelyn - the GP did say I could go back whenever, to discuss options. Since I turned down the offer of counselling, and she didn't feel it was safe to give me medication (ODs too frequent, and I can't guarantee I'm able to get out of the house weekly to get smaller prescriptions), there's not a lot else she could do. She was nice, which is more than I deserved considering I was using her time selfishly.

Change - I can't function in relationships. I know how that sounds. I can't deal with having friends, or with having to "check in" with people. I am not happy alone, but it is easier than the alternative. Even if I was able to deal with it, I don't have anyone with whom I could work in that capacity.

I can't remember why I posted. It felt logical last night, though even as I was doing it I knew I shouldn't. I've been too scared to open Chrome all day (I'm logged in on Chrome, and use other browsers for other websites). I don't even know why. Scared of people confirming what I thought, probably, even though I know people here are far too kind to do so.

I don't know who I am anymore. I don't know what is a public persona, and what is real. That sounds ridiculous. It is. I am. I really don't want to be arrogant, that's a horrible quality in anyone. I'm sorry. Really, I am.

I was in two minds about writing that. But it's the one thing that really sticks with me. It also horrified me, (I had the same reaction as you did initially) but it - it's hard to explain - was the one thing he said that shocked me out of the place where I was, made me realise that I couldn't go on as I was and that I needed to let someone who was willing spend time with me, help me. It took the burden off of me, thinking that I was being selfish and wasting their time, and allowed me to accept that it was something I needed to do. It was no longer 'my choice' to go to the sessions because he had made the choice too and if I cancelled he always made sure that I rearranged. I felt I had to because he expected me to. If someone wants to give their time to you, the only non-arrogant thing to do is accept it, else you are saying their time is worth nothing to you. It was probably the best thing he could have said to me and the only thing that convinced me I had to keep going back. It challenged how I saw the world and how my logic worked.

And what you say about the doctor, that you were using her time selfishly, is bollocks. It's her job. She was being paid, (by the sound of it for doing nothing). You are doing her a favour by visiting :p

I think you posted because on some level you know you are desperately unhappy, you know you need help from somewhere and you don't know where from. You need some reassurance that you are not alone. And you're not, we're here, waiting for your next update.

It does not sound ridiculous, does everyone not behave differently in public to in private? (I genuinely don't know the answer to that question, I always assumed it was yes but I don't know if that's just because I do I assumed that's how everyone works). Whatever it is, it is exhausting. I'm going to send you a pm.

Hi to offer a different perspective. It reads like the gp listened to you, tried to offer compassion and kindness ( a less kind dr would not have used what you felt were trite phrases, a less understanding dr could have contacted social care or health visitor immediately if you and children, a less understanding dr may have done a referral to a psychiatrist against your wishes). And said you could go again. And offered you the two options gp's have, counselling and medication rather than offering neither.

You could ask for weekly prescriptions to be ordered, I do mine online so do not leave the house to do them and they get sent straight to my local chemist. Would that help?

Some children's centres offer different groups you could try to help if you want a different approach? Some areas have Samaritans offices where you Can go to talk to them. D not rule out phoning or emailing them either as an option for listening at a specific moment.

Margarita, I've replied to your PM. Missed replying to the last paragraph, though. To my knowledge, most people don't behave massively different in public vs in private. Obviously, there are things that people do in private that they wouldn't want an audience for, but most people's core personalities are the same.

Hoophopes, I don't have children. I know that means I shouldn't really be here. I was linked here a long time ago from another website, and never left. It felt a logical place to post because it felt safe here.
I know the GP offered what she could (she didn't actually offer medication as she didn't think it would be wise right now). I didn't expect more from her. I wasn't trying to be negative about her; like I said, I thought she was nice.
I wasn't aware you could do prescriptions online, though it does still leave the problem of getting to the chemists. In all honesty, even with weekly prescriptions, I don't trust myself not to stock-pile.

Thank you both, sorry for being a nuisance. I can't tell whether I'm being paranoid or if it's justified. How do you tell the difference?

I don't know how to finish this post. There's no way I can say how I feel without sounding like I'm either about to top myself (I'm not) or being a total drama queen (even though everyone already thinks that I am one). Sorry for being so me.

Hi - some medications can be done by injections, what is called a depot injection. you just turn up (think most are fortnightly) every time to wherever the nurse does them. Not sure which medications are available that way, as an alternative.