Category Archives: self harm

High Stakes Gambling

I wrote some time ago about coming across the idea that bipolar disorder[s] is an ‘allergy to stress’ and oh boy, if that’s true then the run up to a general election, whilst working 3 jobs and having no confirmed employment after August is like bathing in peanut oil/sleeping in a hay bale/other extreme exposure to common allergen.

I have been riding some fairly extreme [within the context of cyclothymia] highs and lows this past month of two. A couple of weeks ago I had one of the most glorious, free wheeling, ‘good god have you noticed how extremely attractive I am’ periods of hypomania I’ve had in literally years. In fact, it was so pure, I began to believe I wouldn’t experience its corollary.

Of course, I was wrong.

It began to float into view last week.  Like the edges of your vision darkening, or when sea mist starts to roll in and you look to the horizon and can’t quite make out where you can normally see too, but you’re sure it used to be further.

This particular low is everything the hypomania was not. Or, more accurately, the absolute inverse of everything the hypomania was. I was confident, felt sexy and sexual, energetic, funny, articulate, optimistic; now I’m defeated, heavy, pessimistic, distracted and forgetful.  Reflections, which began in conversation with a friend, on my own [experience of] gender that had seemed so intriguing and freeing, have become an internal monologue, a weight, and a source of fear.

I started smoking again. I self harmed.

It’s hard to deal with times like this. I write, often, about the ways I try and manage my cyclothymia through my lifestyle. Generally, I try to stamp down on my impulse to really let highs run unchecked and don’t indulge them by drinking and not sleeping.

But sometimes the allure is too great, the release from the everyday is so welcome, and the energy that runs through me from head to toe is just liberating.

I can’t really eat gluten without getting a lot of pain, and getting quite sick. An NHS consultant advised me to avoid it. Every now and again though, I smell fresh bread in the supermarket, or see a particularly mouthwatering-looking cake, and I think ‘fuck it, the pain is worth it’ and I gorge myself for an afternoon, or a day. As I double over in pain the next day – or sometimes just a few hours later – I usually think “I really should stop doing this, it’s not worth it”. But then the pain subsides, I stumble back out into the world and I sort of…forget.

Stress will keep coming; there will always be something to tip me over into another hard cycle. And the option to ride the wave of unsettled mood as far as it goes will keep presenting itself to me. As long as I can survive the lows, actually hang on through them to the other side, is it really the worst thing to take that pay off from time to time?

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Filed under hypomania to the rescue!, self harm

Just ‘doing it for attention’

I’ve been haunted by the accusation that I am ‘just doing [whatever] for attention’ since I first heard it levelled at people who self harmed, and then my fear deepened when a friend at school accused me of it in response to my not eating.

Fear of being thought of as ‘attention seeking’ as a teenager meant I hid every element of my unhappiness.  I was petrified that someone would discover my self harm and call me an attention seeker, so I painstakingly covered.  For a decade.  And I was afraid I would be called attention seeking for not eating, so even when the school nurse cautioned I was ‘under weight’ I didn’t say a word – and publicly laughed at such an absurd assessment.

The difficult thing is, I think, that these actions are attention seeking.  But bear with me: probably not quite in the way you’re thinking.

Teenagers, in particular, are going through unparalleled emotional, bodily, and cognitive/intellectual changes. Their social relationships are radically rearranging themselves as they re-orientate themselves around peers rather than family, their bodies are changing in very obvious ways in terms of puberty and hormones, but they are also changing into the shape that will likely determine how they experience much of their rest of their lives.  More than this, they are exploring increasingly intense and sometimes romantic relationships, and learning about the pleasure their bodies can achieve in consent with others. They are coming to terms with ideas like mortality, and able for the first time to take responsibility for assessing risks and gambling their own safety.

Looking back on who I was as a deeply unhappy 14-18 year old, I still don’t know how to fully articulate that experience, or how I could have communicated the sense of being lost in my own body, baffled by my new and changing emotions, isolated from my [seemingly] entirely-heterosexual surroundings, and the fear and exhilaration I was encountering as I began taking risks with drugs and alcohol.

What I can see when I look back, is a young woman trying to ask people around her to help.  I did want attention – I wanted someone to show me how to navigate that transition in my life, I wanted someone to tell me my feelings were as significant and life-altering as they felt, I wanted someone to validate the depth of the things I felt without calling me “dramatic” (another favourite accompaniment to ‘attention-seeking’). In a sea of other teenagers, all struggling to find themselves and each other, I wanted to be seen.  I needed attention that distinguished me from the crowd (‘bloody teenagers’) and reassured me I was valuable.

My heart aches for how isolated and lost I was at this time – how desperately I wanted someone to notice the physical actions I was taking to ask for help, and how entirely unable I was to do that verbally.  Ultimately, two parents of my friends, two of my best friends, and a girlfriend, helped me in the ways I needed.

Subconsciously, I think altering your body through self-harm and disordered eating are, ultimately, actions which some part of your mind knows will draw attention.  Faced with a total lack of language for those feelings, or the skills of reflection and introspection we develop into adulthood, how else can young people communicate their need for care, for guidance, for help, for attention?

As adults, we’re expected to move away from these actions, to develop different strategies, to recognise that harming ourselves as a cry for help is ’emotionally manipulative’.  As I understand it, one criteria which is used to identify and diagnose borderline personality disorder relates to ‘manipulative’ or ‘attention seeking’ behaviour and I know a number of people with symptoms/moods similar to mine who have been diagnosed with BPD, apparently largely because of their long term self harm. I also know many of these people have repeatedly sought psychiatric help, have repeatedly asked, calmly, clearly and with specific evidence of need and defined goals, for emotional support from the appropriate health care providers; and they have been turned away.  What can you do when expressing in words, in ‘acceptable’ ways, your need for help is unsuccessful?

I  know someone who works as a NHS Psychiatrist and is called to A&Es to assess people in crisis – usually at the point they are expressing suicidal impulses or engaging in actions of self harm.  This psychiatrist can only recommend people are admitted, but cannot create the NHS beds for them to be accommodated.  These people are also, ultimately, turned away.  They might return, ever more desperate, ever less able to communicate, ever more extreme in the physical actions they take. The chronically underfunded NHS, teetering on the point of collapse, ends up labelling these people “attention seekers”.  And, implicitly, that means ‘not in need of attention’.

Attention seekers, in an age of YouTube and Facebook and make-your-own-celebrity, who instead chose to endanger their lives and permanently alter their bodies rather than start a blog (hey-oh!) or a YouTube channel or an Instagram account? Something doesn’t add up there, does it? If this was about seeking ‘attention’ there are a hundred easier routes to it.  Self harm, suicidal gestures, and disordered eating, and a hundred other self-injurious actions are about seeking attention, but not any kind of attention.  Attention – help – for chronic, overwhelming, unmanageable experiences of fear, pain, anxiety, loss or some other catastrophic emotional state.  They are the last refuge of people who either cannot discover the words to convey their emotional state and their need for support, or who have communicated their desperate need for help and not been heard.

Why else seek attention through actions, unless because nobody is listening?

My conclusion is two-fold.

On a personal note, I remind myself of all of this as I wrangle self-harm impulses.  I don’t want to self harm, what I want right now is help with these unmanageable emotions of stress, anxiety, and fear.

More generally; that attention-seeking is not bad, or wrong, or evidence that there is not a mental health condition, an emotional need underlying it.  That we must care for, and be patient with teenagers in particular and be cautious not to dismiss their actions as dramatic or (most hated of words) ‘angst’.

People ask for help in many ways – often it is not with words because those words are either not available, or not heard.

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Filed under NHS and Professional Services, self harm

Thinking about chronic mental ill health

I’ve been reflecting recently on the way I view my own mental health.  I write often on here, and on twitter, about hitting a ‘hypomanic period’ or a ‘depressive period’ because, as I leap from one to another, I think of them as separate events.  But not only does a hypomanic ‘period’ inevitably lead into a depressive one, they aren’t isolated incidents.  They are, cumulatively, cyclothymia itself.

It’s been useful (necessary?) for me, up to now, to think of them as separate events which I pass between and through rather than thinking of them, along with my ‘stable’ periods, as a whole, and a connected manifestation of cyclothymia.  I needed to think of them as distinct periods which had clear starts and ends because then I am not always ‘within’ cyclothymia – I didn’t know how else to conceptualise it, how else to describe it without suggesting it defined my entire life.  Increasingly, this kind of thinking has made me feel more despairing about experiencing highs and lows; why can I never stamp those emotions down permanently? Why do those feelings keep resurfacing when I beat them down last time? What am I doing wrong that I can’t win the war?

I’m thinking, today, about the language of chronic illness.  I found this article an interesting read: 5 ways you’re not ‘living’ with chronic illness which recommends some shifts in how we think about our own chronic ill health in order to prevent it taking over/directing one’s entire life.  When I decided to stop therapy and come off meds I believe I addressed the first point – stop looking for the why.  There are many, many theories from genetic to social and beyond that propose reasons why individuals develop cyclothymia and other conditions; none of them offer me a solution. So why was I pursuing treatments which offered me little help but were founded on one or more of those theories?  As I’ve said before, med free is not the right choice for everyone, but I got so little from the various drug treatments I tried, walking away instead of pouring more energy into finding the ‘miracle’ cure for me was the right way to stop living under cyclothymia and start living with it.

Point 2 is also something I’m fortunate I’ve been able to achieve.  

Point 3 gives me pause though; you’re not living with chronic illness if you’re hating yourself.  Self-loathing is both symptomatic of cyclothymia and caused by it.  I, like many other people I have spoken to with this illness, have lost things and people that mattered because of some of the ways cyclothymia manifests itself in both action and personality.  And, as I mention above, I come to hate myself for not being able to fix myself, for not being able to simply step out of this restrictive jacket of cyclothymia and into a life of cheerful ease.  Which leads me, as it does the article, into point 4; you’re not living with chronic illness if you’re fighting it.  This doesn’t mean stop trying to improve my health and manage my illness; it means accepting a paradigm shift from thinking of it as something to be ‘cured‘ or ‘fixed’ to thinking of it as something to be managed, contained and yes, as the article’s title says, lived with.

I am not failing because the ups and downs keep coming. I am not [and I struggle to write this, but I must try to explore the idea] unlovable because I have mood swings.  I am coping.  I am managing to get through my life in lots of ways that are great, and celebratory.  I am not a fighter – I am resilient.  Winning (if we must persist with the language of a fight) with chronic illness like cyclothymia, means carrying on each day and finding and using new ways to make life easier, moods more manageable, and life more fulfilled.

For example, right now I’m once again in a particularly brutal down-swing.  And I find myself compulsively harming myself; simply to contain my emotional extremes, in order to, for example, prevent myself from crying on the bus home, or from weeping during a party.  If I think of each down-swing as a separate event, I have no explanation for my self injurious behaviour.  

If I think of all my down-swings as part of a single experience of mental ill health (which of course, is precisely what it is and why my entire emotional experience is diagnosed with a single condition) then my current behaviour is simply a resurgence of a symptom I have less frequently than some others. It’s just a ‘flare up’ of one of the least pleasant elements of this illness. And if that’s true, it’s not that I’ve totally failed to maintain my previous progress, it’s just that, this time, the down-swing is particularly intense and as long as I keep moving forward (point 5 from the article) after this, and keep thinking of what I can do to make those symptoms less destructive and emerge less frequently (perhaps by identifying what has pushed me that bit further this time – stress?) then I am living with cyclothymia. I am still in control.

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Honesty is the best policy

I started this blog with the intention to share my experiences of living with cyclothymia, and some of the things I’ve learnt to make life a bit easier.  I’ve had a great response to some of the posts I’ve put up so far which has been really gratifying, and I’m working on a cyclothymia FAQ based on search results that are bringing people here (and please feel free to submit your own questions – and answers if you want – in the comments and I’ll include those too).  The flip side, however, is that this aim has become self-silencing.

I don’t have all the answers – I struggle with cyclothymia from month to month but also, sometimes, from day to day.  If I can’t tie up an experience with a “and this is what I’ve learned” I’ve become disinclined to blog about it.  I’m also reluctant to admit that dealing with cyclothymia is not an up and up process.  There are as many steps backward as there are forward ones.  Things go wrong. I fuck up.

I’ve been through more than a month of near constant cycling; straight into a high after every low, no respite, no calm.  My highs have been anxious nightmares, my lows have been crushing, numbing, long.  I spent 12 days sleeping for no more than 6 broken hours a night.  I argued with friends and family and ran away to the other side of the country for 3 days.  I’m self harming occasionally.  I’m failing miserably at maintaining any kind of schedule, getting work done, or socialising.  My occasional honest tweets or conversations where I reveal how I’m feeling are causing friends to become concerned for my well-being which in turn causes me to fall into a guilt spiral of self recrimination and self loathing.

I’ve idly considered going to my GP and asking for a referral to a psychiatrist to discuss medication options but then I remember how many medications I’ve tried over the years, the total disregard for my wishes last time I tried to tackle cyclothymia with meds (“oh you have horrible side effects on a mind-blowingly high dose? Tough luck. And no, we can’t discuss other options. I’ve met you twice now so I’m discharging you back to your GP.  No, I still don’t care you’re not happy with this treatment”), and the massive amount of ambivalence out there in medical-knowledge-psychiatry world about whether treating cyclothymia with meds is ever a good plan.

So here it is; cyclothymia really bites.  It’s biting really hard right now.  It’s sunk it’s teeth in these last few weeks and I can’t shake loose.  And I’m not managing to always win, or even sustain my small gains in some places.  It’s not an easy road. And more than once this week I’ve wished for a new brain.

That’s how it is.

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Filed under asking for help, medication, NHS and Professional Services, self harm

Wearing my heart on my sleeve

I spoke in therapy the other week about the frustration I feel at having to bare my soul every time I bare my arms, I’ve been continuing to think over those thoughts and feelings ever since.

Don’t get me wrong, I’m not under any allusion that I have especially severe scarring, or that I am worse off than people with burns or other scars.  This is not a pity party, this is just me talking about what it’s like to walk around in my body.

I self harmed from the age of 14 to somewhere around the age of 22, 23.  I stopped self harming on a daily-ish basis at around 19.  Inevitably, cutting and burning oneself for that period of time has a considerable impact on your skin.  My arms are pretty scarred up.  Year on year, as I continue to abstain, the scars fade a little more but it’s going to be a long time before they really become unnoticeable – or even just easy to miss.

Until May last year I had never ever worn short sleeves to work.  So that’s roughly 10 years in work wearing long sleeves in every weather – even the stiflingly hot days.  In May, at a conference at the University I work and study at, I broke.  I was wearing a thin jacket over a t-shirt in 30 degrees.  I was running around organising things and I realised that if I didn’t take my jacket off then, at 9:30am, I’d have sweat stains from armpit to ankle by the end of the day.  So I whipped off my jacket and did the day in a t-shirt.  Presenting my research to colleagues and superiors with my arms on show.  Hosting an all day event in an t-shirt.

That evening, stress and exhaustion and lack of food combined to make me roaring drunk after 2 glasses of wine.  At dinner I confided in a friend and colleague that this was the first time I had ever worn short sleeves in a professional environment.  Something flashed across her face before she spoke – relief I’d mentioned it? Horror I was talking about it?  She confessed “yes, [other colleague] and I spoke about [your arms] earlier, do you still do it?”.  “No,” I replied “not for years. But that’s just the problem, I have to carry around my teenage self and all her decisions for everyone to see.  Lots of people did stupid things as teenagers, but I can’t avoid people making assumptions about me based on what they can see, I can’t leave my teenage self behind”.  She sympathised but assured me that our work environment – a university – may be one of the best places to be ‘out’ about something like this. I’m sceptical about that, but that’s another post.

There was a lot of compassion and understanding in the conversation I had with my colleague that night, but her first response, the very first words out of her mouth confirmed what I always fear – the scarred flesh of my arms is a topic of conversation, it is worthy of remark.  I have been approached by strangers in the street in the summer who demand to know what is ‘wrong’ with my arms, I was cornered by classmates in Sixth Form accusing me of self harming and demanding I confess it to them, I have been asked by waiting staff, shop assistants, security officers.  Somehow, for some reason, visible signifiers of mental distress make your body public property. People believe they have the right to demand an explanation from you, to insist on [one way] emotional intimacy.

I can have a great day, sunning myself on the beach or in the city, shopping, laughing with friends, living life in the most enjoyable and energetic way but a single person, a single remark from a stranger can cut through all that, bring me crashing to earth feeling small and exposed.

“What’s wrong with your arms? You cut them, didn’t you?”

Having self harm scars is like walking around with a mental health hangover.  Always forced to reveal more than you consent to people you don’t know. Always knowing that whilst friends and colleagues might be understanding, might not care, it will invariably come after a gasp, a whispered conversation, a furtive look.

Perhaps it’s surprising then, that my primary response is anger.  You ask me directly, with no preamble, with no intimacy, what is ‘wrong’ with my arms and I’ll reply “nothing. What’s wrong with your face?”  Say “did you cut your arms?” I’ll say “no, I raise tiger cubs”. Call me a liar, I’ll call you a dick.

My body, not yours. Not yours to demand an explanation of, not yours to judge me by, not yours to know me by.

Anger is the big front to the awful, gnawing insecurity I feel about my arms.  I wear long sleeves to avoid these questions and assumptions, not to save anyone difficult considerations.  I wish the scars away sometimes.  But I also think of them as a part of my journey as much as the various tattoos I have.  Would I vanish them all tomorrow if I could? Almost certainly yes.  Although one of the biggest roles they play in my life today is as a disincentive to self harming again so I waver slightly at the thought of maintaining that resolve without a reminder of why.

Perhaps most frustrating is that whilst the scars on my arms hint at a past and mental health history, they don’t tell the whole story.  They give half a picture and a million assumptions and stereotypes about what a ‘cutter’ is.  They don’t say “fought past that, deal better now, in control, managing a whole other condition these days”  They don’t say “I’m more than this” They don’t say “you see one thing, but you don’t know what it means, where it came from, or where I’m going”.  And, somehow, they make me into an awkward teenager in the eyes of people who would otherwise see a thirty-something.

Scarred arms leave me no choice in who knows what, or when.  And that fucks me off.  But I’m not angry with myself – I’m angry with those people, those strangers, who think they know something about me because of it.

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Filed under self harm, symptoms and habits