Precious venlafaxine

I’ve always read things and been told that missing doses of psychiatric medication can really mess you up. Thankfully I’ve been quite good at remembering to take my tablets, but yesterday evening I realised I had forgotten to take my morning venlafaxine. 

Quickly the reasons why yesterday was such a horrible day became clear. But even with the knowledge I hold about medication, I was surprised how awful I felt only missing one dose. 

The urge to self harm was incredibly strong throughout the day, I couldn’t concentrate even on the television without images of my thighs ripping open bursting into my mind. 

I ended up crawling into bed around 2pm because it felt simply like it was too painful, tiring and overwhelming to be awake. The longing to sleep forever more was even more overwhelming. 

By the evening I had a weird feeling of energy, I had a glass of wine and tried to watch television. My mind was racing and I wasn’t concentrating on anything. 

As the evening went on I wasn’t feeling the usual tiredness I should feel at that time, and after that it was as if I went into a slightly manic state. I felt absolutely ecstatic, I decided 11pm was the perfect time to play hide and seek. I was finding everything I was doing utterly hilarious. 

After a few hours I felt like I was on a comedown from speed. Eventually my body slept but I still don’t feel like my mind was resting. 

I woke up today feeling all over the place and tearful. As soon as I was awake this morning I took the venlafaxine and I’ve never felt so much relief taking tablets. 

I owe a lot to venlafaxine, I know it’s the reason my suicidal and self harm urges are more easily kept at bay. Again, even with the knowledge I have on medication, I never really ‘believed’ properly in anti depressants until I started venlafaxine. But, in reality it isn’t far off a life saver at the moment.

The voice

I wish I didn’t have a voice in my head that randomly says ‘wow don’t your thighs look big?’, or ‘you must really regret that bowl of porridge’. 

How can you kill a voice that lives inside you, goes everywhere with you? How can you destroy it once and for all? Maybe you can’t, maybe it will live inside me forever. 

I’ve started seeing a private therapist and as terrifying as it is I know I need to put everything I have into this or I won’t get better. 

She said it’s okay to feel like Ivor lost my identity, or rather than my identity simply is an eating disorder. I am completely defined by my illness, as it dictates every day of my life. 

Keeping food diaries is horrible, scarier and more stressful than I thought it would be. 

Having to be truly honest about the demons inside my mind is even worse. 

I hope there is a light at the end of this tunnel. 

Walk away quietly

I’m sure I won’t get better. 

For as long as I really can properly remember, my every day life has revolved around my eating disorder. 

I am certain this is just what my life will always be like. Can it be fair that I can be destined for such a miserable existence? Or does fate not exist at all? Or am I meant to rid myself from this existence and hope for a different world, a different life. 

I know many people are ill for years and years and years, I have only been in this battle for seven years, but it feels quite long enough. It has peaked and troughed, sometimes feeling quite bearable for a couple of months at a time. 

But some sort of hurricane hit me six months ago and it spiralled out of control completely. 

My life is not my own. 

It is dictated by the demon in my mind. 

I want a life of normality, without terrible urges and thoughts. 

Seven years is not a long time in the grand scheme of things, but it really is quite long enough. 

I’m able to cover most of the cracks for short periods of time, able to work a day here and there just to feel like the person I used to be. 

In reality though, that person is gone and now Beelzebub controls my body. 

I have little fight left, I know it isn’t time right now to give up, but I also know I don’t have another seven years in me. 

I think when you are fighting a war you know you simply can’t win, it is nicer to walk away quietly. 

World mental health day

Speaking about mental health is probably one of the most difficult things to do. For some ridiculous reason, many people still hold the medieval thinking that mental illness equals shame and weakness. 

I started this blog to document the inner most thoughts and feelings I have surrounding my mental health. 

I have received a hug, huge amount of love and support because of this blog, but there are still numerous times I have started writing my thoughts down and chickened out of posting it. This is usually because I’m afraid that once I press post, it means those thoughts are there for the world to see, it leaves me open and vulnerable, but most of all it means that people can see the darkest and most secret parts of me. Very often sharing those parts of yourself can help someone else, or at least raise awareness. But sharing those parts is terrifying.

I have written posts that I have not published because I don’t know how others will react, and unfortunately because I’ve been ashamed. 

This is a very sad fact, that I can say I’ve felt ashamed of my mental health, even after two years of psychiatric nursing training, even after working in various mental health organisations, even when it is 2017.

I’m sure so many people feel the way I feel. Mental health is petrifying, isolating and absolutely all consuming. My own mind has the power to destroy everything I hold close to my heart.

How do you stop your mind turning in on itself, screaming and tearing everything apart?  

Today I had a bowl of mango chunks and raspberries and a yoghurt for breakfast. Then in the evening I had some fresh prawns and lettuce. 

My mind is screaming at a thousand miles an hour. That’s too much to eat. I know all the facts and figures, I know what calories the body needs to survive properly, I know I haven’t eaten over a couple of hundred calories, I know all of this. It makes no difference.

My mind is racing and screaming. Diet pills, laxatives, nothing even makes a difference anymore. I take them because it’s almost as if I don’t remember how not to take them. But nothing helps, I still ate. I have days where I can’t get out of bed because I’m so exhausted of fighting this fight. Days where giving up seems like the only thing to do. Days where I cannot look in the mirror. Days where I am just wishing for a way out of this nightmare. 

This is something I am deeply ashamed of. I question over and over what on earth is wrong with me? There are parts of the world that are starved of nutritious food, people who would give a leg to eat what I have the option to eat. Yet here I am, crying over some mango. 

I am ashamed of the suicidal thoughts I have. I feel huge guilt over the thoughts of ending my life, because I have so much to live for. 

Yes I have an eating disorder and depression, but people face a lot worse in their lives don’t they? 

I feel ashamed to admit that my nightly routine consists of taking 15-20 laxatives. I feel quite disgusted that I inflict that on myself, because some people endure horrendous physical illnesses like bowel cancer. I’m sure these people would pay a large price to not been bound to the bathroom for hours on end. Yet here I am ripping my insides apart over a bowl of salad and prawns.

These thoughts of embarrassment, shame and guilt pace around my head every day. 

But I am wrong to feel ashamed. I am wrong to compare myself to anyone else, disease or no disease.

I have experienced first hand from an immediate family member how it feels to be told your mental health is silly, to be told to ‘just get over it’, to be made to feel invalid. 

Mental illness is VALID. Your mental health is so valid. 

It is 2017, we have put man on the moon. 

We have split the atom, we have created electricity, created penicillin and vaccines against diseases. 

We have developed technology to such high levels that we can now FaceTime people on the other side of the world. 

How can humans be so advanced in so many areas, but so backwards when it comes to mental health. 

It is now time we accept mental health in every form it takes. It is time we open our eyes and give acceptance to every soul that struggles. 

Where I am may be lost

I can't remember the last time I wasn't in pain. 

Not only mental pain but physical too. I get huge discomfort if I eat more than a salad or half a sandwich a day. 

Every day, at one time or another, I'll be in pain from laxative use. This ranges from hours of stabbing pain that can wake me up in the night or stop me from sleeping, to just an hours pain when I first wake up. 

It’s usually when I’m in this pain that I think I simply can’t carry on like this. 

I get a right feeling in my chest and heart palpitations from excessive amounts of diet tablets. I get headaches due to lack of food and drink. 

Yes I’m alive, breathing and I have many, many thing to be grateful for, but what quality of life is it to be ruled by an eating disorder? To plan every day around the needs of the disorder? To put the needs above the disorder above everything else? 

I ask myself over and over why I do this to myself, as if I have any choice or control. 

Mental illnesses take control of people and make us lose touch with who we really are.

So many people who suffer with eating disorders hide it, I hid my problem for years. I pray one day the society we live in will be more open and people will not have to hide the truth. 

'I am not lost for I know where I am. However where I am may be lost' - A.A Milne 

Dragging the weight

Today my care coordinator discharged me from the CMHRS, stating there wasn't anything else for them to offer me, she said although my weight is under what it should be it isn't of critical concern and that I still weigh too much to be able to access the therapies I feel would help me.

This came as quite a surprise after I saw her two weeks ago, when I said I felt I should discharge myself as the work her and I were doing wasn't helping me and she could not accept that I didn't want to treat my eating disorder as self harm. Her view was that we had to delve into my life to find what had happened to me in order for me to self harm by restricting food. 

For me this isn't what my eating problem is about. 

I know abuse and trauma are often key parts of why people become mentally unwell, but I also know that I am not suppressing abuse from my childhood or some traumatic event. 

I told that if she didn't understand that and see it the way I do then I'm wasting their time. I said I would rather contact a private therapist who could work through issues with me and stop focusing on the eating being a form of self harm. Of course restricting food intake can be classed as a form of self harm, but I do not do it cause myself pain or to torture myself for some reason. It's quite the opposite, as not eating makes me feel good. 

She told me I was due to get a new care coordinator today, as she was going to a new job, and she said hopefully the new care coordinator would have a different approach that I would take to better.

So today I turned up ready to meet my new care coordinator. Only to be told that they had discussed me after my last appointment and decided yes I could be discharged. 

My care coordinator said that my consultant had said if I didn't want the clinical management work around self harm then there wasn't anything else they could offer. 

This upsets me, not because I feel rejected from their service but because I have always backed up the NHS. Through it's constant criticism I have always believed that the NHS is a wonderful thing that we are lucky to have. In my job I've been on the receiving of a lot of criticism from patients and families, I always saw their side but also thought 'patients don't see how hard it is for staff, they don't see the lack of resources or the lack of staff, they don't understand that we are doing our best under immense pressure'.

Now, when I talk about the NHS I don't mean physical care. I've had a lot of physical health care hospital stays in my life and the care has always been amazing. 

But the mental health side is lacking so much. 

It isn't nurses fault that there isn't enough money in the NHS, but for nurses and doctors to state so bluntly that you just aren't thin enough for help is almost cruel? I could never even imagine being so blunt to a patient about something that is clearly such a huge issue for them. It left me feeling as if I wasn't taken seriously at all, and made me question if there's even anything wrong with me. 

When I asked my consultant what help I could be given for my laxative addiction, she told me to 'just cut down on them'.. as if I hadn't ever thought of that?

People speak of an obesity epidemic that's hit the world, what about the mental health epidemic? 

So much of the NHS is amazing and there are brilliant mental health services but they are so few and far between. 

Having a mental health illness is like carrying a weight tied around your heart. Some people manage to drag themselves along with the weight, stumbling through life. Some, over time, learn to balance that weight and live a decent life. Others cannot lift that weight alone. 

I've spent the last five years lifting those weights for people. That's what I want my career to be built around. If I can find a way to drag my own along and carry on. 

??

Will I ever be happy with who I am?

As I am now, I have very little energy. I have huge bags under my eyes, my hair comes out in big clumps and snaps at the ends and I've half most of the muscle mass I had. My knowledge on nutrition and the human body tells me I would feel physically better if I ate more and put on a bit of weight. But my brain tells me I can't do that because it may give me more energy in the short run but it will make me feel even worse mentally. Even more depressed and digested and repulsed. 

My knowledge tells me that I am underweight and that's why I'm tired. 

My mind tells me I'm still too fat so I can't eat anymore than I do. Infact I need to keep cutting down what I eat. My mind tells me that people don't think I look thin enough. People think I look a normal weight, probably chubby. 

My mind tells me you have to push harder because 'normal' is too big. I am at constant war with myself because I know logically what is healthy and what isn't. I see people who are healthy weights and people who are overweight and I know they look beautiful, they look attractive and good. So why can I not be happy like that?

For years and years I've restricted my intake, trying never to max 500 calories a day. Clearly some days I do go over this but many days I manage to stay well under. The feeling of only eating an apple is exhilarating in many ways. Like a power that runs through my veins as if my brain is saying fuck you to my body and to science, I don't need to eat. 

But as exhilarating as it is, it's also detrimental to me physically and it's exhausting. 

So how will I ever be content with who I am? 

Will I actually ever know who I am? Will I be constantly at war for the rest of my life? If so, what sort of a life is that? 

The eye of the tornado

Today is the day I should have got my results for the end of year pharmacology exam. The exam that takes you into final year and brings you that step closer to qualifying as a nurse. 

But I didn't get my results as I didn't get to sit the exam. 

Instead my life was, once again, dictated to me by my illness. 

In the same way that my illness dictated which friendships I'd lose, the same way it broke my year and a half relationship. My illness decided it would also change my career path. 

Granted right now I am only having a year out of university, so my career path could stay the same I many ways, and only be delayed by 12 months. But it will be different, because I am different. 

There is no guarantee that I'll go back to university. There is no guarantee of anything really. 

Mental illness is a difficult pill for anyone to swallow, and being in the midst of it almost feels like a tornado. You are pulled this way and that way, pushed down and down and constantly smothered by it. 

It is hard for everyone it touches, not just people who have the illness but their friends and families too. When I first became unwell I thought I could list easily the people who would stand by me, but if I had listed 10 people then I'd have only got 3 of them right. 

You see who is left standing when the tornado hits. 

Along with the people you expect to stand by you, you also expect to still have your job or your university course. You expect, and hope, things could stay the same. 

But the tornado is in control, not you. The tornado is set to wreak havoc and isolate you.

I'm so bitter and angry. So bitter about the relationships I've lost during the last six months. I'm so bitter that my degree has been put on hold. I'm angry that I have no control. 

I am a tiny, insignificant pawn in the eye of the storm.

Happy Monday

I sit on the floor in my hallway, my cat is meowing next to me, scratching at the front door. You want to escape too do you, kitty? Her big eyes stare at me, as if she's saying Catharine just get up and open the door for me. But if I did that, you might never come back to me. I wonder if she knows I'm different now, I wonder if she recognises me anymore. Animals have instincts don't they, they sense when something is wrong, they sense danger and even sadness. I wonder if she senses that I've lost myself. 

I sit there reading an article written by someone recovering from an eating disorder, she writes that she always felt a fraud, like a bad anorexic, because she never fitted what society class as being someone who is anorexic. 

I don't really know what my diagnosis is anymore, but it doesn't make a fucking difference anyway. Some professionals throw around the word anorexic, some say ednos, some think I've simply been abused as a child and won't admit it. But I remember the first time a nurse said the word anorexic, I nearly laughed out loud. How could I be? Didn't she see the rolls of fat through my tshirt? What was she talking about. 

It doesn't matter about the figures and statistics. It doesn't matter that I meet the generally required for diagnosis bmi of less than 17.5. 

I'm still not thin enough.

She was crazy. Everyone is crazy. Maybe I've gone crazy. Maybe my mind has slipped away. I've lost my fucking mind. Beezlebub. 

The situation is dire

There are 202 NHS beds for children and young people with eating disorders. On top of that there's a handful of private hospital beds with NHS funding. 

I'm not sure of the exact number for adults, but when you think how often eating disorders start in adolescence, this figure is disturbing. This situation is dire.

I am, by no means, someone in a bad situation, not in comparison to other people. 

This is not a pity party. But I am someone who is told repeatedly that I am not thin enough to get help, I am still too heavy. My consultant psychiatrist sat opposite me a few weeks ago and asked in an ideal world what help I would like, I replied that I wanted therapy around the way I view food, the way I view gaining weight, in order for my brain to understand that healthy weight gain is not a negative thing. She smiled at me, and said 'oh well you don't weigh little enough to get that sort of therapy'. Again, this is no pity party, but I sat there weighing 45kg. 

Yet that is still too much. 

Therefore I am given 'general' mental health help, from a team once a week, who see people with a range of mental health difficulties.

Although I am grateful for this help, the team I see do not specialise in eating disorders.

When I was referred I was told I was an 'urgent' referral. From my course, I know urgent referrals have an assessment target time of a week. I waited four weeks for my assessment.  

In a way I was lucky, as I only lost a handful of pounds in those four weeks. But for other people, those four weeks could be detrimental. 

As well as the physical side of losing weight, there is also the mental side, and a big deterioration can happen in four weeks. 

I know I will never recover through the help I am getting now, and I am lucky I can choose private help. But not all people have that option.

The situations, the waiting times, the help, everything that people with mental health illnesses face have room for improvement. But people with eating disorders, above all else, are massively overlooked, pushed aside, under-treated and made to wait for far too long.

Having trained as a nurse and worked in several different mental health teams, I know all too well that the money isn't there, there aren't enough beds or staff or agencies to help everyone.

It's all over the news that we are constantly slamming health services for not doing enough but, again having worked in many services, I know that professionals are doing all they can do. There just simply isn't enough of them.

Eating disorders become chronic and completely take over your life. 

The best way to beat eating disorders is to catch them before they become chronic. All I can really say is if you know someone who struggles, or if you are struggling, look for help through your GP or online services like b-eat and look for help before it snowballs into even more of a hellish nightmare. 

The nightmare

I've tried really hard with eating in the last week or so. I'm hardly ever having a day where I eat nothing. I've even bought oats, wheat flakes and dried fruit to make my own cereal. 

Yet every day is still a huge struggle. I can't let myself put on weight, I still have to restrict and laxative. I can't carry things I used be able to, I feel pathetic. At one point last year I could lift 120kg on a calf press. I'd give anything to be back in that place. I have a constant headache, my legs ache and I get tired doing simple tasks.

My hair still has days where it comes out in big clumps. My energy levels are still rock bottom and my mood is still dark a lot of the time, but I am trying.

I wish I could see an end to this. 

I wish I could just avoid mirrors or thinking about myself.

When I see my reflection I wish I could rip the skin off my body. My skin burns with this repulsive, strange and foreign feeling. As if my body is not my own anymore, it belongs to a darkness, not to me. The darkness feels all consuming, Beelzebub alive and breathing. How can there be an afterlife consisting of Hell, surely this is Hell now.