Worried and unsure

[Messupmum]

I've got to make a decision whether to be discharged from the cmht next week when my cpn leaves, or get a new one for a month or so while I get used to new meds.

I'm currently having weekly group therapy, which I'm finding hard and don't feel comfortable at yet. I think I have a bpd diagnosis as well as depression and anxiety.

I've been under cmht for approx 18mths, had too many cpn changes in that time. I have attachment issues and deal with changes quite badly.

I've not been good recently, currently under crisis/day hospital and this is where I had a meeting which left me sobbing. They let me leave early in this state. I asked for a phonecall today as I feel confused and low. Nothing so far. I'm scared of being left with no support very soon. I don't feel ready, but I'm worried I'm coming across as needy and pathetic. I am so confused and don't know what to do.

A psych ward really is a last resort. They're not great places to be full time. Lots of sitting around being very bored. Always being watched and that before you get onto the lack of privacy, lousy food and arguing over shite TV. Being supervised as I shaved my legs was enough to make me go hairy.

Its not so good about the CPN though as it sounds like you still need support.

I don't have a CPN, I have a social worker as my care co, and only see the CPNs when in Crisis, which has been a while thank fuck. Maybe they could move you to a SW instead? Mine is lovely and very supportive.

I was so worried about a reply to my ranty posts now. I'm in tears now. I get this anger and jealousy inside of me, which makes me behave in a way I dislike.

I don't want to go into a ward. I know it would be awful. But I feel I'm not getting through how desperate I feel, but I don't know what I'm asking for. Maybe I'm fine, I just want to end it and have urges and plans, but it feels normal for me to think that now, so people ignore me.

It's any kind of care co-ordinator I'll be getting discharged from, my first cc was a sw, I find they have all been similar in their approach.

I'm scared about tomorrow, I feel like not going, and driving off somewhere. But I'm not quite ready to say goodbye to dd yet.

I see what you're saying - its more that you don't know what to do to get through to them how bad you're feeling.

Are there any local support groups near you? I found so much support from our local volunteer group, much more than from the professionals at times as they're not tied up with a large case load and also because they've been where you are. They're very good at listening too.

Could you look into that? Your Care co should be able to give you some direction.

I think you have had such a difficult time and you are certainly not getting the support you need.

I think you need a very structured approach from your CPN/Care-co with regular meetings and phone contact as needed. I think it is unfair you don't seem to be getting this. Having a PD shouldn't mean that you get less support but in reality it seems it can end up like this.

I am wondering if the CMHT are thinking of discharging you because you are so stuck in this crisis. I know it doesn't make sense but I wonder if they are thinking that because nothing is changing with them, maybe you would benefit from not seeing them. I don't think it is a solution but that might be their reasoning. I would chat them about this, and be clear that you feel you do need on-going support.

What is the group therapy you are having? Is it specially for BPD?

I can see why you are getting frustrated because you seem to pass between day-hospital and crisis on and off and there is no sense of moving forwards. It can be horrible being stuck in a crisis and not seeing a way out. I am sure you have been told this but ultimately you have to be the change, however you need (and deserve) the support to get you through this so you can find out what needs to change for you to move forward.

Take care

Sorry if I suggested the wrong thing by saying a support worker may help. Where I am based support workers help the patient do whatever it is their head is stopping them from doing. Helping them get out and about ( with or without dc), and generally are given to people who have been under day hospitals and crisis teams etc to help move them forwards.

Can you tell the MH services what help and extra support you want. Be specific? It may be as fluffy said that they are changing provision because what they have tried has not worked. In which case ask them what support you will have? If you can tell them what you need, why and how it will help you recover you may get a different answer. Hopefully.

Thank you for your support. I wasn't offended by the support worker suggestion, was just explaining why it hasn't been offered.

Lying here wide awake with so many thoughts going through my head. I panic when I can't sleep. I can't switch off.

Lara, I agree. Living somewhere there's only 6 female inpatient beds in a 40 mile radius, no day hospital and a 9 month waiting list for the psychiatrist and 12 for the psychologist, it really is a postcode lottery, the way that MH patients are treated.

I'm on my 3rd CareCo in less than 12 months because of staff shortages and it's disruptive. Fortunately, I don't have an illness that makes change difficult, but it's still tricky having to start from the beginning again.

I also thoroughly dislike the way that people with PDs are treated most of the time in most areas. What can't be just medicated is treated as too time consuming it feels.

Hi Messupmum. Have you gone to the hospital yet? Please do that and take all the support they are prepared to offer you. Make sure you tell them exactly how you feel, don't hold back because you are embarrassed. They won't take you seriously if you don't tell them everything. You are ill and you need and deserve to be helped. If you had pneumonia or a broken leg you wouldn't be beating yourself up over it. Insist that they help you. Take care of yourself as well as you can.

I feel awful. I'll let you know how it goes later. Don't know why I'm so anxious, I wish I didn't care so much. I feel like sh'ing but they'll just think I'm doing it to stop being discharged.

Can you write down how you feel and give that to the doctor to read? It might be easier than verbalising your feelings.

I agree that you should speak up and say how you feel - though I know that is easier said than done.
A lot of MH nurses don't know how best to support someone with BPD. In fairness, there's not much of a focus on treating BPD in nurse training - it is weighted towards caring for people with psychosis or mood disorders. At least that's my experience (am a CPN). And that knowledge/skill gap shouldn't impact in the care you receive so please don't think I'm making excuses. I've worked with many people who have BPD and what seems to help many is an intensive therapy programme over a 6 month period (group and individual therapy). I think if we were all to complete a personality questionnaire we'd all score high on one or more marker for a disorder! I am frankly in awe of how some people manage when they've had such a traumatic past. I'm not sure I'd cope quite as well. So you are strong even though you don't believe it & if you can find the courage to tell the treating team how you feel and what you need it will empower you even more. If they don't have the skills or services to help you they should refer you to somewhere that does. Good luck.

on (fat fingers!)

I got discharged from the day hospital without being asked if I felt better or worse. I had a quick meeting with someone I hadn't seen the whole time I'd been there. I couldn't talk for crying so much. Got a last appt with the cpn tomorrow, then I still don't know what happens from there. I'll try to talk to her tomorrow, I need to tell someone about these urges that are turning into vague plans.

i think thats shocking u have been discharged when your feeling like this. i was meant to get discharged by the cmht in november but when ibtold them i split up with my partner they changed my mind and am still seeing them, which am glad cuz am not coping very well atall at the moment. could u try and persuade ur cpn to change there mind about discharging u?

I now have a meeting with a manager at the cmht next week to discuss things. I can't talk about things without crying, so probably a good thing I've got no one to talk to. I feel so angry with the day hospital, some of the staff were understanding, but I was given someone different every day. I know it's short term, but I was given the minimum time with no questions asked.

The meeting sounds encouraging. At least to find out who is in charge of your care whilst you still in therapy etc. what you should do if struggle etc. And monitor medication. Hope it goes well for you

I hate day hospitals personally. I had a similar experience to yours by the sound of it. I prefer just being under the crisis team. At least they may not be helpful but they do the odd home visit and actually talk to people. I would love to do an undercover programme on how useless I found the day hospital ( activities finishing early, starting late, cigarette breaks by staff in patient time, not a great choice of activities etc!!! But that is my own little rant and one experience - hopefully there are better ones!!!)

I can feel myself starting to feel on edge. Slept really badly the last few nights, I've been taking my meds so I don't know why I'm starting to feel overly anxious and edgy. Sometimes it's so hard to cope, all I want to do is hide under my duvet for a week.

It's taken me ages to type this, I've made too many mistakes this week, finding it hard to think straight.

Sorry things are so hard for you, can you have a duvet day this weekend?

Hi - do you think it is because it is the weekend. Do you find weekends harder? (I find time off work and holidays harder, which I know sounds weird). If so being kind to yourself and not doing too much might be helpful. Can you get other people to help care for your dd so you can have that duvet day if it would help?

Sorry sleep not great. Do you have any prn medication you can take tonight to help sleep? Or ability to have a lie in to catch up on sleep?

Weekends aren't good. Thinking a lot about an od. It gets to a point when it's hard to distract from those thoughts.

It is good you realise weekends are not great. I was wondering if they were difficult for you. Not nice though that they are horrible.

Can you talk in your therapy about weekends and find out strategies people find helpful?

I find weekends and holidays really hard - not at work, no routine, no child care, the pressure to enjoy them etc. So for me what works is trying to plan some things into them - even if it is the food shop, but not too much, and then record things on the tv that I want to watch and save them for Sat and Sun nights. And have treat foods etc. Sounds simple but took ages to work out for me that I had to be kind to me and what being kind looked like for me.

What distractions work? What would help tonight to not only keep you safe but to make it as ok as possible?

I've had a couple of drinks which isn't good, as I feel more impulsive. Some weekends are ok, but I think the last few weeks of struggling is starting to take it's toll. I can't cope, I have no money, no life, I'm letting everyone down. I'm in two minds whether to go and get more alcohol or do something else, this has to end at some point. It will happen one day, I feel like I'm just putting it off.

I was told I could ring out of hours crisis and they would 'triage', but they didn't. They asked my name and fobbed me off. Feel very much hated.

Ok thanks