Sectioned On An Acute Psych Ward For More Than Five Months

[capz]

I would like to share my experiences of lived and on-going mental health problems. Belonging to an affluent Pakistani background I was privileged with a healthy and decent upbringing and education.

During my adolescent years there were moments I felt lost, confused and distant with reality and often low in mood. Regardless I persevered with my education, successfully completing my 'A' Levels at a Grammar School, I then completed an undergraduate degree in Manchester and was awarded an upper 2:1 in BSc Psychology. At this point my mood dipped considerably and I began restricting my diet. This was not acknowledged as an problem at the time and I immediately began to study a one year MSc in Psychology in Leeds and achieved a merit for this one year degree.

As time past I lost more weight but engaged intensely in working in the mental health field and spent the evenings at the gym. Concerns were raised by colleagues, friends and family due to my gaunt physical appearance, but I refused to process this as an illness in my mind. Eventually I diagnosed myself with anorexia nervosa and felt confident I could adequately manage it myself however soon bulimic traits began to appear, I would spend the day at work, evenings at the gym, have no calorie intake at all during the day and then on a night time I would binge and purge. Lack of sleep, intense exercise, depressed mood I became very withdrawn and emotionally unstable but maintained a professional approach to my work.

After some time my health began deteriorating and I sought help from my GP who referred me to a psychiatrist. After a few consultations I began disclosing information about my personal life, a traumatic life event and expressed thoughts of suicidal ideation and self harm. I was diagnosed with BPD with comorbidity of depression and eating disorders. Subsequently I was admitted briefly to an acute Psychiatric ward and discharged a month later and received intensive psychological therapy in the community. I felt fully 'recovered'. This period of remission was brief to say the least.

As the months turned into years I maintained professional employment and often lectured at local universities in my spare time.

The tolerance of enduring negative intrusive thoughts diminished and I began engaging in self destructive and self defeating behaviours. I often engaged in illegal substance use, binge drinking and slept during the day with the use of prescribed sleeping medication in order to avoid confronting reality and the negative aftermath of negative emotions. I continued to engage in reckless and high risk behaviours which consisted of unprotected sex whilst high on drugs and heavily intoxicated and sedated with no awareness of where I am or whom I was with, frequent self harming and frequent overdosing. I was out of control, impulsive, no longer had insight to my behaviors and the subsequent consequences, and felt lost in a chaos of hallucinations and delusions.

The best way to describe and to contextualise my mental state is cogently summarized by the following quote by Marsha Lineham "People with BPD are like people with third degree burns over 90% of their bodies. Lacking emotional skin, they feel agony at the slightest touch or movement".

Any form of comments negative or positive from friends and family were perceived in a hypercritical manner it was as though my mind began cannibalizing itself.

From October 2013 to present date there have been over twenty five attempts to end life to escape this chasm of brutality in my mind. Accompanied with episodes of psychosis and lethal overdoses over ten admissions to an acute psychiatric wards. Due to the hypersensitive nature of my emotional state I would immediately discharge myself from hospitals and felt no one was even close to understanding my disorder or validating my emotions.

I was stuck in an anxious and self defeating vicious cycle with friends and family alike. I would drive them to breaking point and then switch to a state of helplessness and beg for reconciliation.

Immersed in intense emotions of shame, guilt, helplessness and worthlessness enmeshed with negative psychotic experiences, which often consisted of commands to harm others, the only rational escape for me, became suicide.

I have now been sectioned and detained for more than five months in an acute mental health ward, with no sight of discharge, I have been subjected to a regimented treatment system which is authoritarian in its nature, often ruthless, disempowering and assertive in its approach and ultimately breeds contempt. There are clear deprivations of liberties and witnessing patients become institutionalised is soul destroying.

I feel I have been a victim of fraud. I was disillusioned by years of education and psychological practice, the ethos of which, is to treat the patient with the utmost dignity and respect and to empower the patient to live independent and fulfilling lives, aiding the patient on to the road of recovery with the ultimate aim for them to contribute back to society as responsible citizens.

However, the dynamics and environment of an acute ward has destabilized me further. The application of NICE Guidelines seem non-existent. Conducting my own research (including systematic journal reviews) the NICE Guidelines detail the requirement of a therapeutic environment or community, preferably a DBT led treatment centre to overcome the disorder, in contrast to an acute psychiatric ward which adheres to a medical model of mental health. Therefore I am not receiving the treatment I need, which contradicts Section 3 of the MHA that, a patient is detained for 'treatment'. The only treatment I am receiving is a cocktail of antipsychotics, mood stabilizers, antidepressants and benzodiazepines. I approached a Mental Health Advocate and a solicitor specializing in mental health, I submitted my plight for the correct modality of treatment for BPD which I am not in receipt of currently on the ward. The response to my submissions, with evidence based research for the need for psychological input was disheartening to say the least. The trust adheres to a policy which states any psychological therapy is considered detrimental and not approved of whilst on an acute ward as the patient is considered 'too unstable' for this to take place. The sole recommendation made was the need to refer me to a specialist mental health unit.

My care coordinator immediately began making referrals to

specialist centres but to no avail. Here we were confronted with several issues; 95% of centres of PD units are female only (a clear underrepresentation for males suffering with PD). There are a dearth of units for males which do exist, but for those with a forensic history (does that hypothesize males with PD are more likely to offend?). As I do not have a forensic history such centres would not be suitable for me. Another problem we faced was that the centres which did accept males, rejected my referral due to my level of high risk ironically on their websites and publications they state that referral criteria is including those "with high risk, frequent admissions to acute wards and those engaging in reckless behavior". Consequently I am now stuck on this acute ward despite a high willingness and motivation to engage in psychological treatment including DBT, which is regarded as the 'gold standard' treatment for BPD.

I have struggled immensely on the ward, in comparison to the patients with a diagnosis or label of schizophrenia or a primary diagnosis of psychosis, whom are regarded as having no insight or control over their behavior, they are shown compassion and are excused for their disruptiveness. On the other hand, the label of BPD is vastly misunderstood. They treat the symptoms not the disorder and are viewed as 'treating the untreatables'. I have been subjected to being called a "liar", "manipulative" and "disruptive" by staff and their knowledge of PD is very limited. Their argument has been that as I have a background in psychology, in their words "I have complete control and insight" in to my behavior and therefore I am responsible for all my actions. I am rendered feeling invalidated and I am unable to express the mental torment, distress and anguish I experience on a daily basis. They have failed to understand my chaotic and impulsive behavior and when I attempt to educate and make them aware of the symptoms of PD and its complexities the response I receive is that I am a "challenging and noncompliant".

I then feel curious to reflect on the essence of what it is to be 'compliant'? I'm in a state of conflict, confusion, complexed and compelled to question the very fragments of my life. Given the scientific stance of an atom being the basic building block of an object which can be seen, held, touched and experienced, what then gives creation to meaning and existence? I was told by a consultant psychiatrist, a medical doctor, a mental health nurse, a psychologist and a health care assistant that I should be compliant with what they say and their treatment plan. If I comply with the unwritten and unspoken rules of what the health professionals regard as 'normal' and 'acceptable', my ticket to freedom is a given! Such compliance is considered a success to the prescribed treatment regime and it adds substance to the evidence base so that health professionals can continue with these practices in a quest for medical excellence.

I can comply, I can comply without protest. After all, compliant behavior allows the smooth running of the ward, it fuels the successful efforts of the nursing staff that, they are managing and treating that patient well. By complying to these socially constructed rules I am considered 'fit, stable and healthy', one with no risk to self or to others. I am therefore 'allowed' to be part of society again as a citizen and I can triumph in freedom, simply because I have complied.

I feel not at ease though, I am curious if I do not comply what the consequences will be? If I do not accept their view of reality, their rules, their reasoning of what is right or wrong, by being non-compliant and deviating from the so called 'norm' what label will I be given and how will I deprived of my liberties?

Some minds corrode and grow inactive under the loss of personal liberty; others grow morbid and irritable, but you are only confined by the walls you build for yourself and therefore I offer the following advice.

Mental health problems are psychologically and physically crippling and we often find ourselves in a very dark and bleak position in our lives where suicide is a rational option to escape from the pains and torture of day to day life.

We have all lost a loved one, rendering us in feelings of grief and depression. We are psychologically deprived of comfort we received from that person and the separation fuels depression and physical ailments.

Verily, suffering from schizophrenia, personality disorder, bi-polar or any other mental illness afflicts us with vicious voices, thoughts, hallucinations, delusions and emotions which we are unable to cope with nor live with.

Medication offers some respite, therapy offers coping strategies to deal with the daily anguish but some of us are unable to develop insight in to our mental health to the extent the illness becomes our identity.

Psychiatrists offer diagnoses, a 'label' to categorise us in to a group in accordance with a diagnostic manual, or we are sectioned and detained in hospital where we are left counting the minutes, hours, and days. And discharged until we are considered 'safe' and 'stable' by them to be released back into the world.

Isolation, lack of interest, inability to form relationships, grief and excruciating mental pain diminishes any quality of life, we become lost souls trapped in a clinical and medical world of being subjected to treatment which is considered successful due to the evidence base, and are left reeling with the awful side effects.

I just want to say that we all have to endure the darkness to see the stars, equally we all endure some very negative and dark moments in our lives but there is always a star shining which will give us support and courage.

We all must offer support, sympathy, empathy and encouragement to each other. We should help each other in our road to recovery and respect the problems we are facing. Yes, there is always no simple answer but who better can help you than a person who has experienced such mental torture themselves. Consultants can spend 6 years of textbook training to help someone, and the medications do offer some relief but essentially we should help each other as we have greater insight and you have experienced and felt the pain too.

I read a quote somewhere.. 'If you do what you've always done, you get what you've always got'... There's many ways to interpret it but from what I gather is that at times we must change our approach to life, and thinking patterns and replace them with a positive mindset. But to do this it requires a level of insight, courage and power and in our weak moments such elements of strength are not there. It is therefore essential we help each other to find solutions, not to dismiss someone's plight of agony and work together to instill some harmony in our lives. Remember don't go crossing oceans for those who won't jump in puddles for you, don't let someone or something to become your weakness. Be aware of your positive and negative points and strengthen yourselves to change and build a life of tranquillity and harmony.

Belonging to a muslim background I often come across the word 'jihad' which in the media has nothing but negative connotations, but when I was studying the buddhist mindfulness approach the word jihad was synonymous with some of those approaches. 'Jihad' means to strive, strive for a better life, health and strive to achieve a level of consciousness where you have insight and are able to govern your own emotions.

I take into account that life experiences can impact our current state of mind, but equally it is us who gives that experience meaning and bring it alive.

Remember you are strong, powerful and have that strength to relieve yourself from mental illnesses. Through peer support, having a shared understanding and empowering yourself can change your entire outlook on life.

Grief, anxiety, depression, psychosis, they are all responses to traumatic events and in some cases a result of organic malfunctioning of the brain and therefore we have little control and insight in to our behaviour. Nonetheless, by sharing your experiences, having positive affirmations and mantras in your life can significantly aid recovery.

The road to recovery is fraught with difficulties and lapses are inevitable but don't feel ashamed or reluctant to talk about your problems. Together we can help each other, together we can raise the level of awareness of our ailments, together we can offer solutions and remedies and together we can help each other to change our mindsets from a path of self destruction to a path of independence, fulfilment and happiness. Please don't give up trying.

[Hopeangel]

Well said!! x

[lonelyheartemma]

Thank you for taking the trouble to share your experiences and thoughts with us. It's sad to read about everything you're going through but that makes me admire your determined and positive attitude even more. What you say is so true and very insightful. Please don't you give up either.

[Kara.]

Capz, I have read your post and I am pleased that you wrote here. I wish you were not in that position but since you are, I hope that you will come out of it and find a way to share your story and your experience of the NHS. You're right. The system is not focused on the needs of the patients but on the needs of the capital. So much that has to be done. We shall continue. There is a lot to be done and I hope. So hang on in there. And don;t give up.

[Threemoons]

Capz, your words have touched me. I imagine the torture you're enduring and it's awful. I want to encourage you. Don't give up on hope, don't give up on fighting. You deserve a better life and I strongly believe you can achieve it. Best wishes for the future. It's a pity that wards aren't centered on the needs of the patients.