An impossible ask

I’m going to start with a massive TRIGGER WARNING. This post contains numerous references to suicidal thoughts and descriptions of methods, as well as intrusive thoughts of self-harm. Please don’t read on if this could be damaging to you.

After last week’s referral I am continuing to see the Home Treatment Team and, as last time, the experience is something of a mixed bag.

By the end of last week I was feeling more and more despondent about my life, in particular about loss of the work and the activism I had so carefully built up over the past few months. On Thursday and Friday I had been scheduled to attend the Royal College of Psychiatrists General Adult Psychiatry Conference as a service user rep, and had been greatly looking forward to this. Seeing people from the mental health community tweeting about sessions I was too sick to attend really hurt me, as did my increasing awareness that I was not going to be well enough to deliver my beloved Mental Health First Aid course at the end of the month.

Not being able to work was (and still is) feeding into a sense of being both helpless and useless, a sense of there being no point to my existence. More and more there seems little point in everything I try to do, to create, to establish when a mood switch that changes as quickly as the direction of wind can ruin everything. All I do feels like building house after house of nothing but cards – from working to get into Oxbridge age 17, through termination of my place as a student midwife and the loss of my probation career, to my current attempts to build a “portfolio career” of research, writing, training and speaking. And so I have been asking my self: why? Why bother? Why strive to be well, comply with medication, keep a daily routine when none it stops the destruction of the things I hold dear?

In the past week I have been spending increasing amounts of time looking at pro-suicide websites – a new departure for me. In particular I was looking into the prospect of obtaining pentobarbital online. Better known as Nembutal, it is a drug I had not thought of since Sixth Form when studying Edwin Morgan’s A Poem for Marilyn which described Monroe’s death in terms of “bewildering barbiturates” and her “Nembutal bed”. It is not easy to purchase pentobarbital, however, or not at least unless you live near the Mexican border. So I read more sites, sites that tell you how to get the best results out of your overdose, how to avoid being found. And so on, and so on. Part of me was observing what I was Googling, noting the seriousness and thinking, “This is not me, I don’t do this” but another part turned its sneaky back and carried on, snarling, “Fuck off! What do you know?”

Meanwhile I continued to have intrusive visions of self-harm. I watched Tom flex his bare foot and saw my own hand slicing the soles of my feel with razor blades. Every time I raised a glass or mug to my mouth I imagined knocking my teeth out. I picked up the kitchen scissors to open a carton and had an impossible impulse to cut through my own fingers, one, two, three, four. Various items in my hand felt destined to be jabbed into my own eye: a fork, a pen, a whirring electronic toothbrush without a head. When I went for an hour’s massage, something that I usually find really helps, I was bitterly disappointed that no matter how good my body felt, my mind was calculating how many pharmacies in the borough I could reach before closing time and how much sedating medication I could get away with purchasing at each without arousing suspicion. And every day I was still having urges to make suicidal gestures likely to achieve little other than physical injury (like wanting run to open the emergency exit at the back of a double-decker bus and jump out into the path of the traffic).

I tried to explain something of this at a “medication review” with the Specialist Registrar on Thursday; I use inverted commas as all that came of that meeting was his recommendation that I try to exercise for ten minutes a day, and to write that down. Um, OK. I assume this was supposed to give me some kind of sense of hope, or control, or agency. It… didn’t. Thankfully I had a much better appointment with the SHO on Friday, who was really only meant to take bloods from me but ended up hearing that I had come to a decision. Either I had to be admitted, I told him, or I had to ask Tom to make good on his promise to take time off to look after to me. I could not look after myself any more, could not reconcile the warring parts of my brain, could not rest assured that the logical, healthier part of my brain would win out over the sneaking, suicide researching part, or over the impulsive, jumpy part. I needed to hand my care over to someone else.

Over the weekend I discussed the situation with Tom and reiterated that I could not take responsibility for myself any more, that I was too worn out and confused, and that although I had fought hospitalisation for 20 years I just didn’t care any more. I just wanted to have someone else stop me from the things I couldn’t be sure I could (would?) stop myself from doing and if took going into hospital to achieve that, then – whatever. And so he has blocked out two weeks of annual leave to be with me, monitor my med intake, watch the post and generally be a hospital at home.

I’m still going to HTT every day, only now Tom is coming with me, as well as spending all the rest of his time with me so I am never alone. Over the past week I have been trying to find out what on earth happened to the referral HTT made to the National Affective Disorders Service when I was last in crisis is April. As usual for HTT I have seen someone different every day, and this has made it very difficult to feel that the matter has been looked into. Because this referral, you see, this was supposed to give me hope back in the spring. It was supposed to help me access the crème de la crème of mood disorder treatment and just perhaps give me a more positive outlook about my future. It is therefore ironic in the extreme that I had basically lost all expectation of every hearing anything about the referral months ago, but with things as they are Tom and I felt that we really needed to get the referral back on track.

Today we saw S, one of the most dynamic and understanding nurses on the team (she even understands how important this blog is to me) and she had done what no one else would, and put in some detective work on my part. She confirmed the national service received the referral on 29^th April this year, but then hit a funding wall – it’s very boring so I won’t go into it, but it’s basically because I can’t seen at my local Trust because that’s where Tom works, and this complicates things. Anyhow, the funding was last chased in August and it doesn’t look like anything has happened since then. S will keep chasing and now so will Tom.

I need this referral, I really do, but also I’m terrified that the thing I have pinned my hopes on for half of 2014 might not deliver the hope and control I need. Because right now even when I feel superficially OK, thoughts of suicide are always there. Tom asked me earlier today what he could do to help as I bent double over the kitchen counter, wracked with sobs. I know what I really want. I want him to obtain the means to help me die, and I want him to hold me in bed in a lovely hotel room under a fluffy duvet as I go. I know he won’t do that. I know it’s an impossible ask because he can’t do that without facing prosecution. But to go, and go peacefully in the arms of someone I love is what I really want.

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