Mental health treatments don't treat dual diagnoses and how i still struggle
People with avoidant personality disorder: avoid social situations or contact with others because they have an overwhelming fear of being criticised, rejected or ridiculed and feel inferior meaning you are often quiet, shy and inhibited in social situations and worry you may cry or blush or do something wrong in social situations and be unwilling to try new things for fear of being embarrassed in front of other people.
This was totally me for many years along with eating disorders meant i just hid in my work helping others as a support worker and teaching horse riding ( where on a bad day my lack of confidence did often end in me crying around a corner thinking i wasn't good enough and self harming when i got home to punish myself for being so useless i thought).
5 years ago when i was my most suicidal i was in a locked hospital for a year and then became dependent after on mental health staff and services to fill a social void as being out of normal society for so long made my social anxieties even worse and although I have a couple of good friends who I have been friends with for years, they have busy lives with work, relationships/married, kids etc...normal life for someone my age. I have always avoided relationships due to my anxieties but that is also lonely. With avoidant personality disorder you don't want to be on your own but just find it hard to trust people, with me a result of the bullying I got throughout school, which was because I was quiet, shy and anxious and cried alot, always feeling not good enough and I have continued feeling the same until now.
I lived at a mental health rehab for 2 years and then have had support workers a few hours a week for 2 and a half years. Originally they were because I wasn't going out on my own apart from to my horse Warwick and even going there on a bad day often meant my mum taking me.
With borderline personality disorder you have fluctuating moods from high to low often over a few hours or days (bipolar highs and lows are caused by chemical imbalances in the brain but bpd moods are caused by relationships and situations for example someone not turning up without letting you know when unstable can lead to feeling suicidal or self harming).Eating disorders also cause fluctuating moods due to fluctuating blood sugars, so there are lots of overlaps in diagnoses.
The therapy I go to is good to deal with some parts of my problems such as being able to not act on self harm thoughts, or rationalise situations such as I often think if people are laughing together they are laughing at me even though they aren't but that also stems from my school days when I would be the butt of peoples jokes etc...stupid things that now sound stupid but I would get hair brushes thrown at me on the school bus saying did I want it for my bushy eyebrows which I then stupidly overplucked and they never came back, if I hadn't have been sat on the bus on my own and had friends it wouldn't have bothered me but I would sit on my own crying all the way home and although it was many years ago it has left its lifetime effects.
I should be and partly am proud that I have challenged myself I did work for 17 years despite my depression and anxieties and eating disorders but sometimes I would push myself too far. I was accepted to train as a mental health nurse but my massive fear of failure and not feeling good enough led to a year long suicidal crisis so although I want to get back to work I'm scared of it affecting my mental health again, I was hoping to do some volunteer work alongside the therapeutic community but at the moment with caronavirus that is on hold which is frustrating. Socially joining choir has helped me so much, I know I say it alot but it is with a group of people who I trust and we are doing something we love together. Choir has been a massive challenge to me as I sang in a church choir for my whole childhood where you stand still and hold a hymn book where as this choir we do dance moves etc. I seriously am so un co ordinated as I'm dyspraxic and my anxiety often means I think I will look stupid but everyone there gives each other the confidence which makes it easier. At the beginning of lockdown I didn't even feel brave enough to turn the camera on or speak on zoom now I enjoy talking to everyone and even sang on my own on karaoke which I definitely would never have dared to do before so I'm so thankful for the support I have had off everyone at choir.
With my body image issues I still often struggle even in the virtual world I often just see how fat I am so I turn off my camera on a bad day or hide off camera if we have to stand up, but 2 years ago when I first joined choir which sounds stupid now I took an overdose the first time I wore my choir red t shirt thinking I looked fat and couldn't cope with how much I hated myself. That was the last overdose I took which sounds stupid as no one else would have thought what I thought there are people of all shapes and sizes in choir and I don't think bad of anyone else just myself. I am proud of myself for no longer acting on those types of thoughts. I love choir gigs and can't wait until choirs can sing together again, I want to work again, Warwick needs me to continue to be a good owner to him, and I'm 40 next year...so much to look forward to.
I struggle alot with my eating disorder, that was what originally led to me starting self harming in 2004 , 2 years after I first asked for help with my bulimia and I finally saw someone in 2009 after my dad complained to someone in mental health services that no one was helping me then I didn't get any actual eating disorder therapy until 2012, 10 years later and I feel if I had been helped earlier my mental health wouldn't have got as bad as it did.
People probably wonder why I can't just be positive and get on with life, you can't just think yourself out of anxiety or depression or an eating disorder that is like a constant self hating voice in your head 24/7 but that's why I like singing so much, "where words fail, music speaks" and whilst you are singing you are concentrating, "when your sad you understand the lyrics, when you are happy you enjoy the music". My mental health will always be a challenge and my many scars are a constant reminder of the worst times which I can't ever get away from but they are from a chapter of my life I never want to revisit but I guess is part of the story that has led me to where my life is at now.
Like I said treatment only treats one diagnosis at a time and eating disorder services only treat people with a low BMI and even then tell people they need to lose more weight before they meet the criteria for treatment which is then just refeeding without headwork and then discharged once a healthy BMI despite how you are mentally, this is a common story across the country but it means people with bulimia or other eating disorders are offered treatment to deal with emotions in personality disorder services but no nutritional/dietitian support or body image work etc. and if a normal person thinks how hard it is to diet without support imagine that but as a mental disorder where you have no control and living on my own I don't even have anyone to eat with regularly which alongside being depressed about living on my own makes that situation a bit rubbish too.
Anyway wanted to do an update as I have lots of different people who don't always know my situation and was just voicing how I am trying to conquer my mental health problems but it's a slow process, I do have positive and negative days, and deal with the negative ones as best as I can. I'm hoping to do a sponsored swim again this year as a positive to focus on again this year, I have a year left of therapy although a bit longer due to the caronavirus we stopped for a couple of months and are now partly on zoom. Afterwards there is a leaves program for upto 2 years but that is once a week alongside whatever you end up doing so I'm hoping to be back working by then, I have been in and out of hospital since 2010 so hopefully this will see me out of mental health services eventually...life has to begin at 40 in February...
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