Please be advised that this post discusses self-harm in some detail and may contain triggers. If you feel this subject matter may be upsetting to you, please be kind to your mind, and avoid reading.
If you or someone you care about are struggling with harming behaviour, visit Mind UK- Self Harm information
I have spoken once before about the breakdown I suffered a couple of years ago. Like anyone who suffers from mental health problems, maintaining my equilibrium is something I have to work hard to achieve. Some days, most days now I’m thankful to say, I succeed. But other times are harder, particularly when physical illness, relationship stresses and frustration at work are added to the mix. After the various CBT sessions, mental health groups and one-to-one therapy I’ve been through, I have a “mental health toolbox” now. I have an increased awareness of my trigger points and warning signs. And I am acutely aware of how vulnerable I am to falling down the slippery slope again.
There is so much written about depression and anxiety, so many films and books and song lyrics. But I don’t think that these can ever truly capture the sense of confusion and fear that grips you when you are lost in darkness and just can’t climb out. If you’re a “control freak” like me, it is especially disconcerting. “My will is always so strong. I can make myself do anything I set my mind to. So why am I spiralling out of control all of a sudden? What the hell is happening to me?”
I’ve spoken before about how I lost hours one drunken night and possibly, probably, planned to launch myself out the fourth storey window of my flat. The days following that episode were scary, but not because I thought I was losing my mind. It was because I was embarrassed and horrified that people I knew would find out and would brand me an alcoholic. I never realised at the time that this had been a huge warning sign. And so, unfortunately, I continued on my not-so-merry way: I didn’t tell anyone, I didn’t seek help, and I didn’t stop to look at what was going on that made me drink more heavily than I had ever drunk before.
The catalyst for me finally seeking help was when, one morning, I was crippled with agoraphobia. I could not make myself open the door and go to work. I was terrified- of something? of everything? – I didn’t know what. I couldn’t make myself stop crying. For months I had been crying in the shower in the mornings, but I would snap myself out of it, plaster a fake grimace of a smile on my face, and go out there and do what I had to do. Why was it not working today?
I made an appointment with a gp, and spent the hours beforehand talking to myself and trying to build up enough courage to go outside. The gp put me straight onto a low dose of anti-depressants and told me to self-refer to CBT.
Now, don’t get me wrong, I think CBT is an incredibly useful tool, and I think that there is a lot to be gained from it. But I’d had six sessions of CBT a few years previous and I felt like I had a fair idea of what it could and couldn’t do. I wasn’t convinced that CBT was right this time. This felt bigger. But, I was willing to take a chance, so I filled in the online referral form and took my place in the queue.
In the meantime, I started drinking again. Not only that, but I started to scratch at my skin with a sharp sewing needle; long, deep scratches that I would rake into my flesh until blood flowed freely. I’d never done such a thing before, and though I’d heard of self-harm, I mistakenly thought it was something that only teenage “emo” girls did. As a woman in her early 40’s surely I was too old for such behaviour. I was being a silly baby, I thought; regressing into childish behaviour. “Becoming an attention seeking brat,” I would scold myself. Just to prove to my “critical parent voice” that I wasn’t doing it for attention, I kept it entirely to myself for three weeks.
One weekend I drank half a bottle of tequila and a whole bottle of vodka, and the next day realised that I had cut up my legs horribly. I felt like I had no control and that I was going crazy. How long, I wondered to myself, before I do something even worse without realising it at the time?
I made an appointment with another gp at my local surgery and, following some very helpful advice I read about online, I wrote everything down in a letter. I knew that I would chicken out as soon as I sat down, and this was too important a conversation for me to baulk and shy away at the first hurdle. I knew now that something was very very wrong with me.
The gp, a doctor I don’t remember ever having visited previously, was incredible. To this day I credit her with a big part of my recovery (whilst not discounting my own achievement, of course. I know how hard I fought.) I handed her my letter, burst into tears, and sat there bawling while she read my words. When she’d finished reading, she thanked me for writing it all down and for being brave enough to ask for help. She didn’t judge me, as I feared someone would, or tell me I was stupid. She took control of the situation, whilst of course explaining options to me and keeping me involved in and informed about my own care. It was what I needed. I was sinking and floundering in deep dark waters, and I needed someone to throw me a life-preserver and pull me, semi-conscious, back to the shore.
It was a long road ahead. My dosage of Citalopram was gradually increased until I reached the maximum dose. I was also prescribed beta-blockers to help with the anxiety and panic attacks. CBT, when it finally arrived, was deemed “inadequate” for the severity of my problem, and so I was referred to a psychiatrist. The psychiatric assessment found that I had enough self-awareness that they didn’t feel I was an immediate danger to myself or anyone else, but I was registered with the local NHS mental health crisis team nonetheless.
I was referred to various counselling services, but as soon as the harming came up, they would apologise and tell me that they weren’t really that kind of service. They weren’t equipped to deal with something like this. Several assessments came and went with nothing to show but a “sorry, we don’t think we’re right for you.”
In the meantime, the harming genie was well and truly out of the bottle, and I progressed to buying pencil sharpeners and removing the blades. I had a little “cutting” kit, as well as a first-aid box full of antiseptics and bandages. Medical and mental health professionals asked me what cutting gave to me, and to explain what I felt before, during and after. I struggled to articulate it, but the best I could come up with was that it felt like I was holding my breath so tightly that I was choking and gasping for air, and that when the blood emerged, it felt like an exhalation. (My therapist later made an analogy with orgasm – a pent up feeling that finds release through sexual climax. She asked me whether I felt there was something orgasmic in the bleeding. I hadn’t really considered it, but on reflection I think this is another good analogy, in fact.)
My gp never gave up, nor did the psychiatrist I saw at the local hospital and, eventually, I was referred to a mental health service and to long-term talking therapy with Mind. Eventually, I learned to recognise my triggers, I learned what to do when I felt the urge to cut, or to drink to excess; how to distract myself, how to rebuild my self-confidence, how to find my way back to myself, how to be vulnerable and accept that vulnerability and feeling of loss of control.
To see it written in a few short lines makes it seem much simpler than it was. I fell off the wagon a few times, but I climbed back on more quickly now. I was a shell of who I used to be, but I learned how to integrate this new reality into my life. Yes, I have a mental illness. No, I am not a failure. I am doing my best in a very difficult situation.
I am better these days, but some days I really have to work hard at it. I still feel immense guilt for the fact that I couldn’t go into work for a year. I still struggle with the financial burden of that, although I am fortunate to work for a public sector employer with a superlative long term sickness allowance policy and terrific Occupational Health care. Others are nowhere near so lucky in that respect, and I can only imagine how difficult it must be for them to have to face the risk of losing their job while they’re trying desperately not to lose their mind.
I don’t know that there is any great wisdom I can impart in closing this account of my own experience of going “crazy”, other than to say to anyone who is going through it now that it is possible to get to the other end, though it is hard, and scary, and you need to be prepared to be vulnerable. But if you are willing to ask for help, there are people who know what to do and how to take some of that unbearable weight from you. At the risk of proselytising, don’t try to carry the burden of your struggle on your own; we all need to rest sometimes and, if you’ve been carrying a huge, terrifying weight for as long as you probably have, you deserve to have someone who can reassure you that it’s okay to stop and steady your feet.
Oh, you know you’re getting really hard to be with,
And you’re cryin’ everytime you turn around.
And you wonder why you cannot pick your head up
Off the ground.
Oh my crazy baby, try to hold on tight.
Oh my crazy baby, don’t put out the light.
From the album “Relish” (1995: Blue Gorilla Records/Mercury)