TL;DR for those wanting to skip triggers: putting myself back on amisulpride, feeling safer.
I made it to the doctors the other day. I’d taken diazepam at some point to get myself through the night, as any time I stopped working my way through distraction techniques I was overwhelmed with the urge to hurt myself.
At this stage the desire to self harm can become something else entirely. This wasn’t just urges but intrusive thoughts, meaning the urge lasts longer than twenty minutes because as soon as I get out of it, my brain winds itself back in. Intrusive thoughts are something everyone gets; the fluttering possibilities our brain presents to us that are entirely out of character. Most people can shrug these aside, especially when you consider that they are normal. Where the difference lies is in the disorders they couple with. For people with Obsessive Compulsive Disorder they can turn into nightmares of what happens if you don’t follow through on the compulsions. For people with social anxiety they can be everything your friends might be saying about you right now, criticising every single movement you’ve made while with them, voluntary or involuntary. For me, with self harm, they are lists of what I can do to myself, sometimes accompanied by gruesome pictures. They’re so strong medical professionals have confused them with voices driving me to harm myself. And if you’re constantly chased by the desire to do something, eventually it becomes, “why shouldn’t I?”.
In the past, when I haven’t felt like I’ve been taken seriously by medical professionals, something else has also arisen. When you’re really ill, people take you seriously. You tell them you want to do something to yourself and they know you’re capable. They rush to get you treatment because you’re “at risk”.
When you stop being “at risk”, when you start being able to ignore the urges, help falls away. You say you want to self harm and the statement that rings unsaid in the room is that now, now you’re capable of ignoring that urge, so why don’t you. Why should they spend time helping you take the pressure off, when they can be off helping someone who is now at risk to take the pressure off. And the desire mounts to be the at risk person, to go back to old behaviours, to fall back into the illness that once claimed every waking moment, so that the things you’re experiencing right now can stop.
It’s not pretty, but that’s crisis.
I haven’t felt that compulsion for a long time. My psychiatrist took me seriously, I’d gotten past the stage of trying to learn who he was as a professional and trusted him. I don’t feel like I’m being taken seriously just now. When I said, “I’m scared of being off these medications”, I don’t feel like I was heard. I tried to trust there was just something I don’t know, not being a medical professional. But I got depressed. I got psychotic. The psychosis lasted longer than usual; a couple of days instead of the few hours I’d got myself down to.
Normally when I take the diazepam everything stops. Psychosis only lasts a few hours, now, so it’s a case of riding through those hours, and diazepam can pull me back to a normal state long enough for that to happen. I took the diazepam to persuade myself to stay awake long enough for an emergency appointment in the morning; so things wouldn’t feel so bad that sleep, as an escape, was less tempting. I was offered someone elses cancellation at 10am. I took it.
The psychosis returned. I wasn’t allowed to exist. I was a pocket of conciousness trying to be more than I was ever meant to be; a person. They would not be happy about this. I shouldn’t be speaking to anyone; let alone leaving the flat to speak to someone. I would be punished. I battled through sitting in the waiting room; the other patients were Them watching me and staying would add to the punishment.
The doctor was the one I don’t like. I’d not been told which doctor it would be but I took my chances for an appointment that day. I half laughed to myself while following him down the corridor; I knew it would be him.
He asked me how I was doing, I said bad. I told him I was depressed and wanted to hurt myself, I wanted to know if a letter had been sent with suggestions for new medications, I couldn’t look him in the face so I looked at the desk. There was not a letter; there was one, now, from the first time I saw her, but that was ended with a suggestion I could come off the medications I was on then, not any new ones. He said he’d try and chase up suggestions on new medications, come back in a week. I asked for a referral to Nanette, and he said he’d do that if it was appropriate.
I went back home, telling myself once I was home I could punish myself for Them. I persuaded myself to eat and sleep first.
Time becomes a bit muddled at this point. I know I woke when it was still light. I know at some point I remembered I’d hoarded amisuplride, over the winter. At some point I realised I could start taking them again, properly, without potentially interfering too greatly with antidepressant plans.
I think I’m two days in, one 50mg dose at night. My head feels clearer. I feel safer. I feel bad I didn’t stick with what the psychiatrist wanted, but I also know what the psychiatrist wanted wasn’t a good place for me to be in. I’m only planning on staying on them until I can get an anti-depressant sorted. The psychosis is stress induced, part of borderline personality disorder, so I figure that once my medications and relationships with medical professionals aren’t stressing me as much, I should be able to come off them.