A Profound Appt with My CPN

Yesterday I had another appt with my community psychiatric nurse (CPN). At first, we went into how I’m doing at the moment. Then my CPN scheduled some appts for me with my nurse practitioner. Last Monday, after all, he and the behavior specialist from my care facility had finally come to the conclusion that I need to do some work on stabilizing myselves and developing inner cooperation before I can do EMDR or another form of trauma therapy. At first, the secretary said the first appt she had available was late December. It turned out to be December 17, so that’s pretty early considering how long I’ve been waiting already.

Then we got to discuss some issues relating to my diagnosis or the lack thereof. These were mostly theoretical, since I have no idea what my current diagnosis is and I really don’t care. I mean, the most recent treatment guidelines here in the Netherlands for complex dissociative disorders, aren’t suited to me (or most plurals, honestly), so I have no reason to want such a diagnosis. All I want is help in getting the inner turmoil under control.

Then I somehow got to mention my former psychiatrist’s comment when first considering assessing me for DID/OSDD in the summer of 2018. She held both of my hands and said: “You have just one body.” Then she went on to explain that, while she was holding our hands, none of us could put our fingers in our ears and pretend not to listen.

We then repeated this exercise. A staff always attends our appts with mental health with us. She now held both our hands and said that we can stay at the care facility. Someone asked cautiously: “Even if I need more help than I get now?” She then reassured us that yes, even if we need more help, we can stay here.

Then the staff asked our CPN what she’s supposed to do when we openly switch, as we had the day before. My CPN seemed not to know, so I suggested she do not elicit it, but do not fight it when it happens either. After all, when she insists that “Astrid” come back, this may create some trouble since “Astrid” is either everyone or no-one at all.

I really hope our nurse practitioner isn’t going to insist people only talk to “Astrid”, as the current guidelines on DID/OSDD seem to suggest as far as I know. I mean, we are okay all listening to the body’s name and won’t sign our names on E-mails or the like when it’s not appropriate, but one of our main issues is that there is no host who somehow “owns” the others. As such, the daily living parts or apparently normal parts or whatever don’t have access to every bit of information needed to cooperate.

Appointment With My CPN

Yesterday, we had an appt with our community psychiatric nurse (CPN). I can’t remember all that we discussed. I went into some detail about our sadness and overwhelm over the last few weeks and explained that we had signed a letter to the manager requesting more help.

I tried to ask my CPN to get me an appt with the psychiatrist to discuss my meds, as my overload and irritability are increasing. While I was trying to get this out, I constantly heard someone in my mind say I shouldn’t be asking this as it’s attention seeking or drug seeking or whatever. I don’t even want a med increase per se. In fact, I’m at the maximum dose for both my antipsychotic and antidepressant already. I might want something to help with sleep and especially the restless dreams/nightmares. I feel intense shame about discussing that though, as my nightmares aren’t your standard PTSD nightmares. In fact, my trauma isn’t your standard PTSD trauma.

That is another issue I’m facing. Yesterday, I read an elementary school friend’s story of child abuse. It triggered me to an extent, because I can relate. Still, my trauma wasn’t that bad. She is a child sexual abuse survivor. I am not. Though I endured some physical abuse, it wasn’t that which caused my complex PTSD and dissociative symptoms. The most significant trauma in my life was the emotional abuse and neglect.

Of course, I just told another survivor that childhood emotional neglect and emotional abuse can cause C-PTSD and dissociative disorders too. In fact, dissociative disorders are largely attachment-based, so anything that disrupts normal attachment, can cause it. Still, to apply that knowledge to myself, is quite a bit harder.

I eventually did ask my CPN to refer me to the psychiatrist. My nurse practitioner would normally prescribe my medication, but he does consult with the psychiatrist also. Besides, I’ve never even seen the psychiatrist. So my CPN was more than happy to get me an appt.

Early November 2020 Health and Wellness Update

Like I said a couple of weeks ago, I had a physical health check-up at the mental health agency. That wasn’t good. That is, my blood pressure was high and so was my weight. Even though the nurse said I might not have gained any weight compared to the last time I stepped onto the scales, as each scale is different, I was pretty alarmed. So was my husband. He asked whether I could be put on a diet. Well, no-one can force me, but I did agree on a food plan with the staff.

Now we’re a little over two weeks on. I didn’t get my blood pressure taken today, as my GP recommended we wait three months and then check it everyday for a week. I did get weighed in though. And guess what? I lost 1kg compared to the last time I stepped onto this scale in early September and 3kg compared to the health check. Only two more kilograms to go and I’m no longer obese.

Overall, I’m doing okay sticking to the food plan. I eat bread rather than crunchy muesli for breakfast, make sure I eat enough veggies and fruit and drink at least 1.5 liters of water a day. That plus coffee, which contrary to common belief does hydrate the body to an extent, and occasionally green tea. I do usually eat a cookie with each coffee break, while my food plan says I can only have a cookie with my evening coffee. However, each day that I skip a cookie, I’m proud of myself for making a healthy food choice. Same each morning with breakfast, which is a real struggle, as I’m not a bread person.

I also make sure I get in enough physical activity. Last week, I felt really lazy, but, according to my Fitbit, still got more than the recommended 150 weekly minutes in active heartrate zones. This week, so far, I got 341. I broke my personal step count record yesterday by getting in over 16K steps. I don’t go on the elliptical as often as I’d like, but that’s because after walking two to three times a day, my legs are often tired.

In other health-related news, I talked to my CPN from mental health about sleep on Tuesday. I usually get enough sleep, but I have very vivid nightmares most nights. They aren’t your standard monster-chasing-me nightmares. In fact, most revolve around my sense of safety here at the care facility. My CPN may talk to my nurse practitioner about it. She said I might benefit from medication to help with this. Thankfully though, having discussed the issue has already calmed things down a bit.

Book Review: Let Me Go by Casey Watson

Last week, I found out Amazon.nl now accepts iDEAL, the Dutch payment method via your bank account. Unfortunately, as of yet, it doesn’t accept this method for digital purchases such as Kindle books. I didn’t realize this until I had already bought a book with my husband’s credit card. Honestly, I think it’s stupid that they won’t accept iDEAL for digital purchases, but oh well. Anyway, looking back maybe I should’ve purchased a book that isn’t on Apple Books, but I ended up purchasing Let Me Go, Casey Watson’s latest foster care memoir. This book came out last August, but I wasn’t really interested in reading it up till now. Read on to see what I thought.

Summary

Let Me Go is the powerful new memoir from foster carer and Sunday Times bestselling author Casey Watson.

Harley, 13, has been sectioned under the mental health act after attempting suicide. She was spotted climbing the railings on a footbridge that crossed a busy motorway and pulled to safety by a member of the public. After six weeks in hospital, social services are looking for a short-term placement so she can be kept safe while family therapy takes place. Harley has a family – a widowed mother and an older sister, Milly, who left home with her long-term boyfriend just over a year ago. There is no prospect of Harley going home just yet though, as her mum, who has learning difficulties and addictions issues, feels she cannot cope. So she arrives with Casey and Mike under a twenty-eight day care order.

As Harley tries to hurl herself out of the moving car on the way home, it quickly becomes clear she is in urgent need of help. Three weeks into the placement, after Harley has made various attempts to abscond, it seems like zero progress is being made. Then all of sudden there is an unexpected breakthrough, and light at the end of a long dark tunnel, but only once Harley is finally able to share the truth about the abuse she suffered at the hands of a very dangerous man.

My Review

This book is a sad look into the errors of the care system. Harley is deemed “care-seeking” (the politically correct term for attention-seeking) by the mental health professionals and is, for this reason, refused mental health care even though she’s clearly at risk. I mean, I honestly don’t feel that anyone in their right mind would make multiple even half-hearted attempts at suicide. In fact, I’m so happy the mental health system here in the Netherlands at least allowed care based on “adjustment disorder” (serious distress due to environmental circumstances) back in my day. It doesn’t anymore, unfortunately.

I was, at first, convinced Harley was at least at risk of developing emotionally unstable (borderline) personality disorder. This can’t be diagnosed in children her age, but it sure seemed she would meet the criteria at some point. BPD is, though, usually a trauma-based condition. So is Harley’s condition, as it turns out.

I had lots of sympathy for Harley, even as Casey and Mike almost lost it with her. This is in part due to the similarities between her experience and mine, but also due to Casey’s caring writing style.

Still, the book dragged a little at first. That’s probably to illustrate how little progress was made at first. Once Harley’s real situation is clear, things after all move more quickly.

At the end, Casey explains some of the issues with the 28-day care order. This was really interesting to read.

Overall, I really loved this book. I should’ve read it as soon as it came out.

Book Details

Title: Let Me Go: Abused and Afraid, She Has Nothing to Live for
Author: Casey Watson
Publisher: HarperElement
Publication Date: August 6, 2020

Read With Me

What Recovery Means to Me

Yesterday, one of the daily word prompts here on WP was Recovery. I didn’t see it till it was already time for me to go to bed, so I’m writing about this word today. Today, I am sharing with you what recovery from my mental health conditions means to me.

First, there are a few things recovery doesn’t mean to me. Recovery isn’t the same as being happy all the time – that’d be an unrealistic goal. It also isn’t the same as independence. I don’t intend on ever living independently again and there are few things with respect to life skills I’d really still want to learn.

Recovery does mean no longer being scared when I’m able to do something independently. Currently, I constantly expect people to overestimate my abilities, so when I can do something independently, I think people will expect me to do it all the time.

Similarly, recovery means no longer being afraid of my feelings, both good and bad. Affect phobia is a thing, you know? I currently tend to dissociate from my feelings a lot. I also often counter joy or sadness with anger, because that’s the easiest emotion for me to express.

Recovery means having a relatively stable sense of self. I don’t necessarily want to integrate all alternate parts of my personality, although it’s okay if it happens spontaneously. We do want to achieve cooperation among ourselves. This also means being able to accept the seemingly opposite sides of me.

Recovery means, as a result of the above, no longer needing to rely on negative coping strategies such as self-harm, rage or impulsive behavior. I will no doubt still have times when I indulge into an unhealthy habit such as overeating or buying stuff I don’t need. That’s okay, since I don’t think total self-control is a realistic goal. I just don’t want to use these as coping skills when feeling overwhelmed, and I no longer want to engage in self-harm at all.

Lastly, recovery means no longer expecting people to abandon me if they know the real me. Currently, I have such a negative self-image that I believe any positive aspects of me are a façade and at the core I’m so wicked no-one should want to be associated with me. Overcoming this is probably the hardest thing to achieve, as expectation of abandonment is such an ingrained thought pattern. I really hope to someday stop seeing myself as one giant manipulator though.

In addition to the word prompt, I am linking up with #LifeThisWeek and #SeniSal.

In Crisis Yet Again #Blogtober20

Okay, this may not be the most appropriate post for #Blogtober20. After all, the prompt for today is “relax”. It is also World Mental Health Day. Most people would use this to advocate for better mental health services, or to share tips on coping with mental health issues. Tonight, I’m too stressed out to do either. In fact, this is just going to be a raw post on my having been in crisis tonight – and not having fully recovered yet as I write this, in fact.

I was on edge all day. By mid-morning, I started feeling irritable, but it was still manageable. When it was time for lunch, a different staff from the one assigned to my side of the home came to eat with us. We also didn’t get the usual weekend lunch stuff, such as sausages, pancakes or soup. We did get a baguette with cream cheese on it. It was okay. IN fact, I much prefer that to our weekday lunches. I don’t think it’s even the fact that I didn’t get the treat I wanted, that set me off, but the fact that so much was different about the lunch. Thankfully, after being on the verge of a meltdown for a bit, I was able to calm down.

Then in the evening, I spiraled into crisis. I don’t even know why honestly. I was getting very irritable about the staff having the TV on even though the volume was turned to low. Within the next fifteen minutes or so, I landed in a full-blown meltdown that seemed to last forever. I eventually asked the staff to fetch me a PRN lorazepam, but then somehow got it into my mind to climb over the balcony railing. I didn’t, but the mere fact that I was standing on my balcony on bare feet in the rain and disclosed my thoughts, worried the staff.

I was near a staff all the time until I had to go to bed at 10:15PM because the evening staff were leaving. They did remove the knob on my balcony door, so that for now I cannot go on there. I gave them permission for this, for clarity’s sake.

The lorazepam has started to kick in, but I’m still pretty tense. I must say that I am completely in awe of how my staff handle my challenging behavior too. It must be hard having a mentally disturbed person on an intellectual disability unit. In psychiatric care, they’d probably have sent me for a time-out off the ward. After all, psychiatric professionals commonly see me as a borderline case. I’m not sure my current place is the most suitable for me, but the staff definitely are.

#Blogtober20

The Kindness of Strangers

Okay, it’s past 2:30AM and I just said I wasn’t going to blog right now, but CrunchityFrog’s prompt for today (well, yesterday) has me thinking. This is supposed to be a daily prompt thing, so I might join in more often. Anyway, the prompt is to write about the kindness of strangers.

I’ve probably written many times already about overbearing, intrusive strangers. Particularly when I was a teen, I didn’t realize that my autistic behavior (of which I was unaware that it was autistic) combined with my blindness often caused people concern. I am more appreciative of people’s attempts, even awkward ones, to help now. That probably changed on the evening of November 2, 2007.

Okay, I’ve shared the story of my mental crisis probably more often than anyone cares to know. Today I’d like to focus on the kindness of the people who helped me stay alive and safe.

As regular readers of my blog will know, I was in a suicidal crisis that evening. I had left the training home I was a former resident of and had hoped to find safety in, because I was told the staff had no responsibility for me and I was to leave.

I took the bus to the city’s train station, talking into my former care coordinator’s voicemail. I told her I was going to take my life that night. I was completely unaware that people could hear me until a woman across the aisle from me started to talk to me. She told me that the bus driver had heard me, which initially only caused greater panic. She kept saying over and over again that he was getting help for me. (“Help”, of course, came in the form of the police, as is customary here in the Netherlands if someone’s safety is in question.) I was in utter shock, constantly crying and very overwhelmed. I am forever grateful for this woman’s kindness. And of course for the bus driver’s. It most likely, after all, wasn’t within his duty to report his concerns to the police.

Looking back, I realize I rightfully worried random people on the streets many times before and they were kind enough to help. Even if “help” meant to call the police. My parents often felt that people were just stupid, assuming that a blind person shouldn’t be traveling independently. Some were, indeed, but in some cases my parents were stupid, assuming that I was just blind.

Self-Care Strategies for Coping with Mental Health Issues #Blogtober20

Today’s prompt in #Blogtober20 is “She Drives Me Crazy”. Many bloggers are using the prompt to inspire posts on organization, decluttering and mental health. So am I.

I’m not feeling too well today. Yesterday, my inner voices started back up with a vengeance. This led to a mini-crisis in the middle of the night. Today I’m feeling a bit low. It may be to blame on my lack of proper sleep last night, or it might just be a bit of the seasonal blues. I hope not, of course.

Anyway, here are some things I do to cope with mental health issues. Some of these are specific to a certain problem, such as depression or anxiety. Others are more general wellbeing tips.

1. Proper sleep and rest. I’ve noticed that, when I don’t sleep well, my mental health goes downhill rapidly. For this reason, I’m trying to get into a better night-time routine. I still use my computer or phone before bed, which I probably shouldn’t do, but I don’t know what else to do in the evening.

I currently am in the process of trying out a weighted blanket, which really helps with relaxation. I mean, even if I don’t sleep, I do rest more when using this. I also use an app called MyNoise, which allows users to customize various mixes of nature sounds or other sensory-friendly sounds. You can set the individual volume for each sound within the mix and there are about 150 mixes to choose from if you have the paid version (which is a one-time purchase of I believe €10,99). Last night, I ultimately fell asleep listening to a soundscape called Patagonia.

I do usually take one hour-long nap during the day. Most days, if I stick to just that after-lunch nap, I sleep pretty well during the night and still feel refreshed the rest of the day.

2. Sensory-friendly activities. I already mentioned the weighted blanket and the MyNoise soundscapes. In addition, I often diffuse essential oil blends into my diffuser. Just today, some new oils arrived, so I’m excited to try them out soon.

3. Staying active. Today is a bad day weather-wise, as it’s been raining most of the day. Still, I managed to squeeze in a walk in the afternoon. I also made sure to stay active and do something in the morning. I made a soap. This is not physically exerting myself, but it definitely gives me joy.

It helps me to stick to a routine as much as possible. Like, I drink coffee in the morning and afternoon, eat my meals at regular times, and do an activity in the morning and afternoon too. I also usually go for a walk in the evening, but today it was raining and the staff were too busy.

4. Mindfulness. I haven’t practised that today, but I find it can help me stay grounded in the moment. I sometimes try a body scan meditation. I also for one love guided visualizations.

How do you take good care of yourself?

For those who are interested, last April, I participated in the Blogging from A to Z Challenge with the topic of self-care. If you click on the #AtoZChallenge tag in my tag cloud, you’ll find a lot of information.

#Blogtober20

#WeekendCoffeeShare (August 30, 2020)

Hello all. I’m not feeling like writing much right now, but maybe by just starting I’ll get somewhere. I just had a cup of coffee and a soft drink. I think the flavor soft drink I had is gone now, but we might still have coffee. As usual, I’m joining in with #WeekendCoffeeShare. Let’s have some drink – there are probably other soft drinks out in the fridge – and let’s catch up.

If we were having coffee, I would ask you how your weather’s been. Ours is okay. Not too hot, not too cold, not too rainy and not too dry. I’ve been out taking regular walks most days. I don’t think I shared this in this type of post before, but come September, I’ll be starting a sponsored physical activity challenge called Steptember. It’s for the cerebral palsy charity. The idea is to get in 10K steps everyday – or as many days as you can get. I find it quite a challenge – both the sponsoring part and the step goal. However, I’m trying.

As regular readers might know, my Fitbit activity tracker broke down some months ago. I’m now using my iPhone’s built-in movement detector to count my steps. That works okay. I did reach the 10K steps on both Thursday and Friday.

If we were having coffee, I would tell you that I spent most of the week escaping into books. I’m okay, but I do need some escapism right now.

If we were having coffee, I would tell you about the appt with my community psychiatric nurse on Tuesday. It went pretty well. We did go in some depth considering her role as just a nurse. She also told me my nurse practitioner was going to refer me to the specialist center on developmental disorders (autism and ADHD). If the information on the website is correct – which I’m not sure of, as the date of the last update was August 27, 2019 and I’m not sure that’s a typeo -, the wait is several months for an intake interview and then another six months for treatment. I’m not sure that’s just for the inpatient units though, as I know that the workhome is part of the center too. That one has a wait of several years due to it being a living facility.

In any case, before I knew there’s likely a long waiting list, I had all kinds of worries and thoughts about it. I mean, I’m hoping to eventually get trauma treatment and lowering my antipsychotic is still on the agenda too. However, I’m very scared either of these could destabilize me. Then again, I just don’t feel my life right now is all it can be.

If we were having coffee, lastly I would share that I spent the week-end in Lobith. It was good. My husband made us hamburgers with cauliflower and baked potatoes, all out of the freezer. I really didn’t taste that about the cauliflower and the burgers and potatoes were delicious too.

As usual, we spent some time together on the couch and some time apart in the two bedrooms. I have a desk in the master bedroom and my husband has his desk in the other bedroom. That one is also used as our cat’s place though.

Then this afternoon, my mother-in-law came to pick me up and drive me back to Raalte. There, I arrived just about in time for my dinner to still be shoved in the oven.

How have you all been?

Bookish (And Not So Bookish) Thoughts (August 13, 2020)

Hello everyone! How are you doing? It’s still very hot out here. We got some thunder far away in the distance here, but no rain. I hope that will change tonight. Though I’m scared of thunderstorms, I really need it to cool down a bit.

early in the week, I got a lot of reading done. I finished Five Feet Apart by Rachael Lippincott on Tuesday. I haven’t written a review yet and it’s too late now to write one today. Maybe tomorrow. Then nothing quite captured my interest. I tried to get started on The Falling in Love Montage by Ciara Smyth, but it’s incredibly slow-moving right now and I’m not sure that’s the book or the weather or me.

I’m still interested in books. I keep looking at ones to download off Bookshare or even to buy, but I downloaded only two books this past week and didn’t buy any. I finally downloaded Bloom by Kenneth Oppel. It’s the first book in a sciFi series. I usually don’t read sciFi, but this one sounded great. Then again, it’s a little long that I can read it in a few days.

I’m trying to motivate myself for doing anything other than lying in bed or eating, but it’s hard. I hope once we get slightly cooler temperatures, I’ll feel more energized.

Yesterday I was in a bit of a mental crisis. I engaged in some eating disorder behaviors and was rather irritable. Actually, I’ve been irritable all week. Thankfully, I could write down my feelings and now I’m feeling slightly better.

I also spoke to my nurse practitioner this afternoon. Next Tuesday, he will be meeting with someone from the autism team to discuss my treatment. So far, this feels good.

How have you been? What have you been reading?