this talk: is about life after discharge from mental health services - with Chris Jones
I've suffered from mental health problems for more than 15 years and have been under the care of different health care services from Child and Adolescent Mental Health Services, all the way through to Secondary Health Care Services in my late twenties. At 14 I was diagnosed with Depression and Anxiety and I was offered anger management classes, counselling, and medication as a means of treatment. Unfortunately, the only thing I found that really helped at the time was the counselling. The stress of my upcoming GCSE's and all the important life decisions I thought I had to make got the better of me and my mental health deteriorated further. I continued with counselling weekly but was also now seeing a psychiatrist who would prescribe me Fluoxetine every 4 weeks. I battled my way through my last few months at school and started college hoping things would improve.
They got worse. I hated college, I never really felt like it fitted in anywhere and the lack of structure compared to school completely disorientated me. I figured that if I just tried to keep busy then I'd have less time to focus on the dreadful thoughts going on inside my mind. I avoided dealing with my demons for a long time when what I really needed was to face them head-on. I still studied full time and took up two part-time jobs to keep me busy, but the temptation to self-medicate with more than what I was already being given by the psychiatrist was too much. Often, I would wake up in a daze, alcohol still lingering on my breath from the night before, sometimes not even sure where I was. I'd take my Fluoxetine, put my happy face on and get on with my day knowing full well I'd be able to have a drink and take my Melatonin (sleeping tablets) later that day and knock myself out so I didn't have to deal with this living nightmare.
I had finished college and was approaching my 18th birthday when I found out I was no longer going to be able to see my counsellor anymore. She worked for the child and adolescent mental health service, not the adult one. As an adult I would now have to move on to adult care services to continue treatment. I felt sick. This is it. This is adulthood. How was I going to cope? I can’t do this. Still childish in my ways, I withdrew completely. I was referred on, but I couldn’t face seeing someone new. Having to start from scratch. Learning to trust someone again. Inside I still felt like a frightened 14-year-old. There was no way I could talk about grown up stuff! I walked away from care services and continued my own path of self-medication and, ultimately, self-destruction. Eventually it all became too much and I attempted suicide, twice. I remember waking up in the hospital the first time and even blaming myself for not doing that right. I didn’t even have control over whether or not I lived or died. I was angry at myself, and then I was angry at everyone else for no other reason than utter embarrassment.
We carried on as if nothing had even happened and sure enough it wasn’t long before I attempted it again, only this time my friends and family were around to witness the whole ordeal. I then saw the damage it caused, and I was devastated. Something had to give. I wanted more than anything to take back control of my life, but I suffered yet another setback. I fell from a window, drunk, and fractured my L2 vertebrae. I spent 30 days in hospital, 28 of those days I couldn’t move anything below my arms incase I caused more damage. So, I was bed-bound flat on my back. Every now and again I would get a tingling, sort of numb feeling in my legs and I would panic thinking this was it - I would never walk again. I eventually recovered with the aid of crutches and a full upper body brace, but my mental health had deteriorated so much whilst I was in hospital that my relationship at the time broke down immediately.
Yet again, I was in a situation where I had been discharged from services (albeit very different circumstances) and had to cope on my own. Then I realised, surely, it’s not just me who’s been through this? Was there anyone else who had been through something similar and also felt the urge to desperately reach out to another person who understood how it felt? The only way I would find out would be to open up about what I’d been through. Once you’ve been discharged it’s so difficult to access help again unless you’re at breaking point, which could be too late for some. I decided that I had to take back control of my life, for the sake of my loved ones. In order for me to move forward I had to remove myself from the environment that was continually reminding me of everything negative that had happened in my life over the years. An opportunity to start fresh arose and I grabbed it with both hands. I took the plunge, left everything behind and moved 60 miles away to begin a new life. Extreme? Maybe. Desperate? Definitely. I had to learn to do everything for myself. Cooking, cleaning, paying bills. But it gave me a sense of purpose and being.
I started writing about my experiences, thoughts and feelings in order to make sense of them and make them REAL. This wasn’t all just ‘in my head’, it was a part of me that demanded validation and it deserved it. That’s when everything changed. That was the moment I knew that I could help other people who could be struggling themselves. Writing gave me the confidence to face my emotions head-on, maybe I could encourage others to do the same. My two main areas of focus in my life were writing and progressing in my career. It kept me grounded.
There were times when it felt too difficult managing everything myself, and I needed a little help. I did seek help through my doctor and took up medication again and talking therapy once a month where I started to also learn new skills from CBT and even began EMDR therapy. A couple of years later though and disaster struck.
Relapse.
It happens, partial or total. Not to everyone, not all the time, but it can. Recovery is not easy, and the journey is unpredictable. Life continues to surprise us, and not always in a good way. Sometimes it feels like there is a little glimmer of light at the end of the tunnel only for there to be another, longer tunnel awaiting you around the corner. When it does happen, you will punish yourself. You will feel guilty and you will feel worthless.
Don’t punish yourself. Don’t feel guilty. You are so worthy.
Relapse isn’t always inevitable, yet it is imperfectly ordinary to experience. The worst thing you can do is punish yourself at a time when self-care should be your priority.
Could this have been avoided? Perhaps. Due to new work commitments I was out of the house for 14 hours a day, commuting for at least 2 of those hours and barely having a break most days. My self-care routine went out of the window and I burnt the candle at both ends.
Some people look at a relapse as a total failure, I know I used to. But it is not. Sometimes a relapse can be beneficial to you, it helps you to re-adjust. A warning sign that your current self-care routine isn’t working, and you need to act. Total relapse due to further trauma or bereavement is unavoidable, after all it is under these circumstances that some of us became unwell in the first place. But you are still here reading this.
As a result of my breakdown early in 2019 I received a new diagnosis aged 28 – Borderline (Emotionally Unstable) Personality Disorder. I now finally had answers as to why I thought and behaved in the way I do sometimes. This explained SO much, even if it did pose other questions about my childhood and my future that I never thought I would have to deal with at this age. My initial reaction was surprise and it felt like another major setback. Or was it? I was given 6 months of intense DBT and new medication, after 10 months off work I felt ready to get back to business, more determined than ever. My new diagnosis isn’t a label that defines me as a person, it was a means of correctly identifying my symptoms and providing the relevant framework for recovery. It offered clarity and an explanation for why I function in the way that I do. It means I’m part of something bigger than myself, a community of people who know what I’ve been through and how I feel. I’d been searching for this for years. My new diagnosis was validation.
By the end of 2019 I was ready to be discharged from Secondary care services. Oh no, there was that word again. Discharge. Only this time, things were different. I’d learned a lot more about how to manage my condition and armed with new skills I was ready to take on the world.
There comes a time (I hope) when you no longer need the hospital visits, the treatments and maybe even the medication. Sounds terrifying doesn’t it? When you have been unwell for so long you start to forget what life was like when you were not unwell. Have you ever had that feeling when you’ve had a bad cold, or the flu and you start to think about all the times that you took breathing through your nose for granted?!
As soon as you no longer show signs of any symptoms of your mental illness people assume you are suddenly cured, and the care and the concern stops too. I’m trying not to sound selfish, but it almost makes you feel like you want to become unwell again, because the support network around you starts to fall apart and suddenly you are on your own. It’s a scary and lonely place to be. When it happened to me, I was desperate to be back in hospital or back in that room with the psychiatrist because I felt so dependent on that, that when it was no longer there, I felt lost. Any form of treatment can actually feel like a comfort blanket in case something else goes wrong. But that’s where your mindset needs to change. When I was at my worst, I felt like the only way I would be free from this living hell would be to end it all. But of course, all this really does is end the chance of you ever being happy again.
The only way to make sense of the chaos is to introduce order.
Life after care services can be tough, but not impossible.
So, be prepared for it. Get all of the information that is available to you and learn as much as you can about how your mental illness affects you and those around you. Take all of the help you can get, every last little bit of it. Join a support group. Share your feelings and emotions openly. Tell as many or as little people as you can and actively ask for their support. Expand your network with new like-minded people you’ve met along your journey. Keep a thought journal. Eat healthier. Drink more water. Limit your exposure to negativity. Keep social media to a minimum. Don’t compare your behind the scenes with someone else’s highlight reel. Set boundaries and learn to say NO sometimes. Self-care is not selfish!
We must understand that some disorders may stay with us for the remainder of our lives and the sooner we learn to accept that as the case the quicker we can be at peace with it and move on. Some, like myself, may even receive a new diagnosis 14 years or more after the first one. That’s why it is so important not to think of a recovery as a temporary process, but to focus on making the small daily changes required to make the most of the life you have right now and manage the inevitable ups and downs long-term. Mental illness recovery is not a destination or an end point, but an ongoing journey of self-discovery. It’s not about simply “getting better” and finding a way back to your old self, it should always be about learning from your experiences and using new skills to create a different path towards a new, better version of yourself.
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