All that I am, all that I ever was…

I am more than my mental health. I am more than my homelessness. I am more than any one aspect of me. I am Addy. And this is…


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The deadly truth about loneliness

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Written by Michelle H Lim, Swinburne University of Technology

Almost all of us have experienced loneliness at some point. It is the pain we have felt following a breakup, perhaps the loss of a loved one, or a move away from home. We are vulnerable to feeling lonely at any point in our lives.

Loneliness is commonly used to describe a negative emotional state experienced when there is a difference between the relationships one wishes to have and those one perceives one has.

The unpleasant feelings of loneliness are subjective; researchers have found loneliness is not about the amount of time one spends with other people or alone. It is related more to quality of relationships, rather than quantity. A lonely person feels that he or she is not understood by others, and may not think they hold meaningful relationships.

For some people, loneliness may be temporary and easily relieved (such as a close friend moving away, or a spouse returning home after a work trip). For others, loneliness cannot be easily resolved (such as the death of a loved one or the breakup of a marriage) and can persist when one does not have access to people to connect with.

From an evolutionary point of view, our reliance on social groups has ensured our survival as a species. Hence loneliness can be seen as a signal to connect with others. This makes it little different to hunger, thirst or physical pain, which signal the need to eat, drink or seek medical attention.

In affluent modern societies, however, turning off the alarm signals for loneliness has become more difficult than satisfying hunger, thirst or the need to see the doctor. For those who are not surrounded by people who care for them, loneliness can persist.

Researchers have found social isolation is a risk factor for disease and premature death. Findings from a recent review of multiple studies indicated that a lack of social connection poses a similar risk of early death to physical indicators such as obesity.

Loneliness is a risk factor for many physical health difficulties, from fragmented sleep and dementia to lower cardiovascular output.

Some individuals may also be biologically vulnerable to feeling lonely. Evidence from twin studies found that loneliness may be partly heritable.

Multiple studies have focused on how loneliness can be a result of certain gene types combined with particular social or environmental factors (such as parental support).

Loneliness has largely been ignored as a condition of concern in mental health. Researchers have yet to fully understand the extent of how loneliness affects mental health. Most studies of loneliness and mental health have focused solely on how loneliness relates to depression.

Although loneliness and depression are partly related, they are different. Loneliness refers specifically to negative feelings about the social world, whereas depression refers to a more general set of negative feelings.

In a study that measured loneliness in older adults over a five-year period, loneliness predicted depression, but the reverse was not true.

Addressing loneliness

Loneliness may be mistaken as a depressive symptom, or perhaps it is assumed that loneliness will go away once depressive symptoms are addressed. Generally, “lonely” people are encouraged to join a group or make a new friend, on the assumption that loneliness will then simply go away.

While creating opportunities to connect with others provides a platform for social interaction, relieving the social pain is not so straightforward. Lonely people can have misgivings about social situations and as a result show rejecting behaviours. These can be misconstrued as unfriendliness, and people around the lonely person respond accordingly. This is how loneliness can become a persistent cycle.

A study examined the effectiveness of different types of treatments aimed at addressing loneliness. The results indicated that treatments that focused on changing negative thinking about others were more effective than those that provided opportunities for social interaction.

Another promising way to tackle loneliness is to improve the quality of our relationships, specifically by building intimacy with those around us. Using a positive psychology approach that focuses on increasing positive emotions within relationships or increasing social behaviours may encourage deeper and more meaningful connections with others.

Indeed, even individuals who have been diagnosed with serious mental illness have reported improvements in their well-being and relationships after sharing positive emotions and doing more positive activities with others. However, research using a positive psychology approach to loneliness remains in its infancy.

We continue to underestimate the lethality of loneliness as a serious public health issue. Contemporary tools such as social media, while seeming to promote social connection, favour brief interactions with many acquaintances over the development of fewer but more meaningful relationships. In this climate, the challenge is to address loneliness and focus on building significant bonds with those around us.

The growing scientific evidence highlighting the negative consequences of loneliness for physical and mental health can no longer be ignored.

The ConversationThis article was originally published on The Conversation. Read the original article.

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Hearing Voices Q&A: What do you want to know?

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A few days ago I had a conversation with someone about my hearing voices. The person I was speaking to is not a voice hearer, and they were explaining their difficulty in understanding this aspect of my mental health. It got me thinking that there are probably many people around the world who have trouble understanding the voice hearing experience. It is, after all, not something many people can get their head around.

Over the years I have tried to explain, to the best of my ability, my own experiences with hearing voices, for example:

But I probably haven’t covered all of the questions that you may have about this aspect of my mental health. Which is why I’ve decided to open it up to you. In this brand spanking new blog series, I’m giving you the opportunity to ask any question you may have in regards to voice hearing and my experience of it. Perhaps you want to know how I handle multiple voices talking to me twenty-four hours a day. Perhaps you’ve been burning to ask when all this started in my life, but were too afraid to do so. Whatever question you may have, I will answer it as honestly and openly as I can.

But this Q&A isn’t just for me. My voices have also agreed to answer any questions you may have of them. So if you’re keen to find out what gets Meadhbh all excited, or what books are Audrey’s favourite, now’s your chance. All you have to do is ask, and they will answer, as honestly as they can.

In order to make it user-friendly I’ve decided to offer several ways that you can ask questions:

If you’re happy for your question to be viewed publicly, you can;

But if you’d rather the question be kept private, you can;

Just remember to direct your question to who you’d like to answer it. Either myself, Addy, or my voices, Meadhbh, Audrey, Vanessa or Shay. This will prevent any confusion and/or avoid everyone offering their opinion when it isn’t wanted.

We’re happy to answer any question you may have, and look forward to opening up a conversation about the voice hearing experience.

So, let’s get the questions rolling! :)

 


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Borderline personality disorder is a hurtful label for real suffering – time we changed it

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by Jayashri Kulkarni, Monash University

Standing in the cold, dark bathroom, she hacked into her wrist with a razor blade and quietly stared at the blood that flowed from the cut. She told herself she was a bad person and deserved the pain.

A part of her felt reassured by the sight of the blood – it showed she was alive – since she felt so dead and empty inside. As she stared at her image in the bathroom mirror, she thought, “I have no idea who that person is staring back at me.”

Such deliberate self-harm is very common in people diagnosed with borderline personality disorder. It takes many forms, including intentional overdoses of tablets with excessive alcohol, risky sexual behaviour, as well as physical self-punishment.

Other symptoms of the disorder include identity disturbances, feeling “dead” inside, rage responses or difficulty regulating emotional reactions to situations, mood swings, constant anxiety and panic, poor self-esteem, memory blanks, dissociation (“out of body” or feeling “unreal”) experiences, problems with concentration, feeling invalid, and fear of being abandoned.

A bad cycle

Between 2% to 10% of the population have some degree of borderline personality disorder, which puts them at high risk of suicide. While it’s poorly understood, we know that it predominantly impacts women.

There’s no medication that specifically treats borderline personality disorder, and it’s associated with a great deal of stigma among both health-care professionals and the general community. Research shows people seeking treatment for self-inflicted harm, including taking medication overdoses, are often seen as “difficult”, a “nuisance” or just indulging in “bad behaviour”.

Rage or diffuse anger is another symptom of borderline personality disorder that’s poorly tolerated by family and health professionals. If the person with the condition repeats self-harming behaviour, frustration among family, friends and health professionals increases and may lead to decreased care.

Since people with the disorder crave reassurance that they are worthy, valid and deserving of care, this rejection sets up a dangerous spiral of increasingly harmful behaviour that’s intended to attract care.

Origins in trauma

About 80% of people with borderline personality disorder have a history of trauma. They may block out recollections of early life trauma, but the impact of their emotional, physical or sexual abuse as a young person is profound and present for many years afterwards.

More specifically, people who were sexually abused as children often feel – wrongly – that they did something wrong, that they are to blame for being abused and that they’re bad people. At a deep level, they believe they deserve punishment; their self-harm acts out this belief.

The rage of people with borderline personality disorder, which often occurs in response to apparently small issues, may actually be a totally justified – a delayed expression of anger with the perpetrator of their abuse. And their memory blanks and out-of-body responses to stress may be attempts to repress recollections of abuse and to escape from trauma.

Not all traumas stem from physical or sexual abuse. Emotional neglect or deprivation can also be difficult for people to identify and define. They can, nonetheless, leave a mark for years to come. About 10% to 20% of people who have borderline personality disorder have no known history of childhood trauma.

Difficult diagnosis

The biology of this poorly understood condition includes the hypothesis that abused or neglected children produce high levels of stress hormones (cortisol) and remain on “high alert” – watching and waiting for the next abusive episode. These stress hormones impact brain circuits and centres that determine anger or emotional control and higher learning.

Deliberate self-harm is very common in people diagnosed with borderline personality disorder. | Rachel Collins/Flickr, CC BY

Women with this condition can also have cortisol-induced cyclical reproductive changes, leading to menstrual cycle-related depression, obesity, diabetes, high blood pressure, increased facial hair, infertility and ovarian cysts. All these long-lasting mental and physical symptoms appear to have their origins in a history of early life trauma with biological brain changes.

There are effective psychological treatments, such as dialectical behavioural therapy, for borderline personality disorder but health professionals have to recognise and explain the condition before appropriate care can be provided.

And many health professionals find it difficult to recognise the condition because different symptoms come and go over time. An overall view of the person’s life is needed to correctly make the diagnosis.

Ill-fitting name

As a diagnostic term, borderline personality disorder not only fails to capture any of the underlying issues and mechanisms involved in producing its symptoms, it also denigrates. In contrast, major depressive disorder describes a serious condition with the key feature of depressed mood explicit in the diagnostic term.

The word “borderline” was used in the 1930s by psychoanalysts to describe patients whose symptoms were on the border between psychosis and neurosis. But today the most common interpretation of the word is that the condition “borders” on being a real illness.

In effect, there’s an invalidation of the illness in its name. This mirrors – as well as possibly enhancing – the feeling of invalidation the person with the condition already suffers.

And all this is not helped by the next word either. To suggest there’s something about someone’s personality that’s disordered – especially as personality is, collectively, the intimate and unique qualities that describe a person – is a devastating blow. And it cuts further into the already diminished self-esteem that people with this condition have.

Why it matters

Diagnostic labels carry a great deal of weight. They describe symptoms, attempt to answer the question of “what is wrong” and lead to a treatment plan. A diagnostic label such as borderline personality disorder with its stigma and propensity to invalidate the person’s suffering clearly has many negative impacts.

A name that captures the origins of the condition, such as complex trauma disorder, could shift the focus from seeing the person as “behaving badly” or not having a “real” illness, to recognising them as a survivor of trauma or abuse. Such a change could improve outcomes for them and their families.

Of course, what’s also urgently needed is clinical research that creates better understanding of the condition, and the development of tailored, effective treatments. But ultimately, prevention of early life trauma would make the biggest difference to the development and expression of this disorder.

In the meantime, changing the label borderline personality disorder to something more sympathetic, even if just informally, may start shifting negative attitudes to people with the condition.


Jayashri Kulkarni is Professor of Psychiatry at Monash University.

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This article was originally published on The Conversation.
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Roadblocks to Recovery: #1. PTSD (Post Traumatic Stress Disorder)

I spent a considerable amount of time yesterday reading through some of the blog posts that I wrote in 2012 and 2013, quite possibly the most prolific blogging period of my online writing career. Some of the posts were depressing, some were uplifting, some funny and others steeped in inspirational content. But the defining characteristic of each blog post that I read was hope; hope for me, hope for a better future, hope for my recovery journey.

Over the last twelve months, ever since I slipped into a deep depression that refuses to lift no matter what I do, I realise that this hope has evaporated. I no longer have hope that I will ever recover. I no longer have hope that my life will be any better than it is now. And that’s the most depressing thing I’ve ever written, for if my life is never going to get any better than what I have now, I may as well kill myself, because what I have now is nothing.

My “life” (if you can call it that) is a monotonous routine of the same-old, same-old every single day. I roll out of bed in the morning only because I need to go to the bathroom. I fiddle online. I listen to the radio. I watch DVDs (almost at the same time each day) and I yearn for something (anything) to happen so as to break the routine that I have fallen into. Sometimes I try to break the routine myself; go for a walk, cook something new for dinner, break up the route I take when walking to the supermarket, but nothing cracks the protective routine I’ve fashioned for myself.

As I read those blog posts yesterday evening I began to wonder why I have such trouble breaking my routine. Why I have no hope for recovery. I started to wonder about all the roadblocks that have been created that are preventing me from continuing my recovery journey. All the niggling frustrations that have been concocted to prevent me from living the life that I want to live. And it is these roadblocks that I need to explore, to try to work out why they are causing such problem and what (if anything) can be done about them.

For until I navigate these roadblocks I will have no hope, and without hope, there is nothing.

PTSD (Post Traumatic Stress Disorder)

PTSD

The first roadblock that is preventing hope from re-entering my life is something I wrote about recently: PTSD. My PTSD is a complex beast. It is not just from one incident, but rather several life-threatening and traumatic incidents that have occurred over the last eight years of my life. From being emotionally abused, to being raped, to being forced to live a homeless, sub-human existence, the memories of these events permeate every facet of my life, forcing me to live in a constant hyper-vigilant state. There are so many triggers, so many things for me to avoid, that ‘living’ is something that seems almost impossible. Even simple acts like someone chewing gum, talking to people or writing comments on blogs can cause crippling panic attacks and hours of re-living the events that have defined my life over the last several years.

Even without these triggers, my PTSD can come flooding back unbidden. I have already mentioned recently the near constant conversations I have with the ghost of my abuser, frantically trying to make sense of what she did, why she did it and why I deserved it. Conversations (nay, screaming matches) that can last for hours at a time, no matter what I’m doing or where I’m doing it. At night, my sleep is constantly disturbed by the near-endless nightmares of being raped, and that is when I can get to sleep, as my efforts are often affected by the memories of my time sleeping rough as my mind constantly asks whether or not I ‘deserve’ to be sleeping in a bed.

Living in such a hyper-vigilant state is exhausting both physically and mentally. Constantly having to be aware of everything that is going on around me, constantly avoiding things I want to do and places I want to go, in case I find myself triggered, in case I succumb to the crippling effects of a panic attack. It’s mindbogglingly tiring. So much so that I often have very little energy to do the things I want to do. I have trouble walking down the street without being overcome with exhaustion, I have trouble keeping my mind focused on even simple acts such as grocery shopping or watching a movie.

No matter what I do, the PTSD has a direct impact on every area of my life. And no matter what I do, nothing seems to alleviate my suffering. I’ve tried everything; from CBT, DBT and mindfulness, to talking therapy, exposure therapy and psychotherapy. Nothing works. Nothing does anything to alter the hyper-vigilance, flashbacks or endless replaying of my previous trauma.

The impact it has on my life is devastating. And the PTSD I’m afflicted with is clearly a major roadblock on my journey to recovery. For as long as the PTSD has such a hold on me, I will never have hope for recovery, let alone be able to recover to any reasonable degree. But what can I do about it? People suggest I should “move on”, “get over it” or “move forward” from the trauma. I’m told to simply stop replaying events. I’m encouraged to just “deal with it”, but these suggestions are nothing more than platitudes that I already know, platitudes that ignore the devastating effect that PTSD can have on someone. It’s not easy to just “get over it” or “move forward” when you are constantly being reminded of the trauma to the point of panic attack and inaction. It’s not as simple as just “moving on” or “dealing with it” when your subconscious mind constantly dregs up memories that you don’t ask to remember. When I’m lost to a PTSD flashback, when I’m trapped in a conversation with the ghost of my abuser, when I’m experiencing nightmares of being raped or being assaulted whilst sleeping rough, I’m not even conscious enough to acknowledge my own name, let alone tell myself to just “move on”. It’s just not going to work. Period.

So what can be done? Well, if I had the answer to that my PTSD wouldn’t be causing as much of a problem, but I need a plan of action in order to rebuild hope, so I have to come up with something. Anything. So:

Firstly, I need to undertake some extensive talking therapy. I firmly believe that psychoanalysis from someone who is trained, someone who knows what they’re doing, someone who has experience of PTSD, will do me the world of wonder. I’m hoping this will come courtesy of the psychologist I have recently been put in contact with, if it doesn’t, then I need to find someone else. Regardless of how much it costs.

Secondly, I need people in my life. People have always been more powerful to me than medication. The most stable I have ever felt in my life (late 2006) came at a time when I wasn’t medicated, when I wasn’t receiving treatment, but when I had friends. The simple act of just being around these friends, spending time with them, sharing my life with them, enjoying life with them, changed the structure of my brain and enabled me to see myself for who I want to be. They distracted me from my issues, took my mind off my troubles and enabled me to enjoy life. Yes, people would help, that much I’m sure.

Thirdly, I need to consider PTSD specific medication. If there is such a thing. I don’t know much about the world of medication when it comes to PTSD, but it’s something that I need to research, something that I need to look into. For if medication can help, I’m more than willing to give it a go. So if anyone has any experience of medicating PTSD, please leave a comment below, your experience would be greatly appreciated.

Fourthly, I need to write more about the incidents that have caused my PTSD, for by talking about them in a safe environment (such as my blog) I may be able to look upon them in a new light. I may be able to alter the way my brain interprets them, alleviating the control they have.

Fifthly, well, I don’t have a fifthly, so four items will have to suffice for now. At least it’s somewhere for me to start rebuilding hope.

Hope is important because it can make the present moment less difficult to bear.
If we believe that tomorrow will be better, we can bear a hardship today.
Thich Nhat Hanh


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Anorexia is an illness – not something we can simply blame on the media

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Catwalk size doesn’t affect anorexia as much as you think. (Republic of Korea, CC BY-SA)

France has joined Italy and Israel in passing laws banning the promotion of extreme thinness in the fashion industry. The health reforms, which include fining agencies employing models with a BMI under 18 and criminalising pro-anorexia web content, have now passed through the upper house of parliament.

An analysis of the reforms by Sarah Jackson on The Conversation suggested that censoring images of ultra-thin models may ease their adverse effects on young women, such as concerns about body image and behaviours such as unhealthy eating.

But while some have been hailing the legislation as a “crackdown on anorexia”, the laws may be unlikely to have any such effect.

Not a lifestyle choice

In western Europe, around 0.5% of adults are thought to be affected by anorexia nervosa. In around 10% of these cases, the sufferers are men. These figures, however, are likely to be an underestimation. It has the highest mortality rate of any psychiatric illness, mostly due to organ failure and suicide.

Yet, the illness is often mistaken by many as a lifestyle choice with an external cause. Despite accounts of the disorder pre-dating the fashion industry, the view that anorexia is caused by comparing oneself to a catwalk model remains popular. Likewise, while pro-ana websites insist that anorexia is a commitment, not an illness, they are highly exclusive online communities, created by and for those already showing signs of the illness. The merely curious are not welcome.

Instead, the link between media endorsement of extreme thinness and the development of anorexia is neither simple nor clear. Research mentioned by Jackson did find that women evaluated their bodies more negatively after viewing images of thin models. However, this effect was small and mostly determined by women’s pre-existing opinions of their figures – women who were already dissatisfied with their body were most affected.

Pre-existing opinions matter. (Joana Coccarelli, CC BY)

As this effect was only measured at one point in time, the effects of prolonged exposure are not known, but when more images were used there was a tendency for the effect to be smaller. Perhaps, as the authors suggested, these images activated, rather than cultivated, beauty ideals.

Whether the effects of media exposure on body dissatisfaction leads to changes in eating behaviour is also unclear. Another study, also cited by Jackson, looked for a link between a person’s real-life media exposure and eating disorder symptoms. The results were fairly inconsistent, with some factors – such as body dissatisfaction – only corresponding to some types of media, and others – such as self-worth – showing no relationship.

More importantly, the research showed correlation, not causation – it is just as plausible that women already unhappy with their bodies seek out thinness-promoting media more often. After all, if such a simple causal relationship did exist, the pervasiveness of these images in our culture raises the question of why the majority of our population is overweight, rather than underweight.

Model bans but no support

Most researchers currently view the cultural value placed on thinness as a “background risk factor”. Meanwhile, several psychological and biological factors are implicated.

High levels of perfectionism, a need for organisation and a focus on details are often observed in those with anorexia. Recent research suggests there is a lower reward response to food in the brain, even after recovery. Some of these factors seem to be influenced by genetic inheritance. Stressful experiences may then influence whether these existing factors then lead to developing the disorder. More than one risk factor will be necessary.

So the legislation is likely to have little effect on the prevalence of anorexia in the general population, but it also offers no support to the models themselves. The law requires a medical certificate proving that a model has a BMI of at least 18. This is still underweight, according to the World Health Organisation. Regular weigh-ins have been only vaguely suggested and there’s been no mention of an obligation to offer support to a model who fails a weigh-in.

A BMI of at least 18 is still underweight. (Fervent-adepte-de-la-mode, CC BY)

While there is some debate over whether models are at a higher risk of developing eating disorders, this career certainly encourages unhealthy behaviour. Thinness of this degree has hugely damaging effects on the internal organs, bones and brain. It can cause obsessiveness and social withdrawal even in psychologically healthy people. France has already lost a high-profile model to anorexia – yet the new laws almost encourage agencies to wash their hands of models who fall ill.

In the same way, while pro-ana content is undoubtedly harmful, the new laws punish those who are in need of help. This exclusively punitive approach is likely to drive these sites further undergound.

If the measures are enforced – if spot checks continue, weigh-ins aren’t cheated and other countries are supportive – they may be a positive move. They may be a first step towards a culture that prioritises health over aesthetics – whether that means a dangerously small or unhealthily large body. Nonetheless, this will mostly benefit the worried well – those who, regrettably, are unhappy with their bodies, but are otherwise unlikely to develop anorexia nervosa. Claiming that these laws address one of the most treatment-resistant mental illnesses is far too optimistic.

This article was written by Rachel Cole-Fletcher, Durham University
This article was co-written by Lexie Thorpe, an MSc in Developmental Cognitive Neuroscience at Durham University

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The DOs and DON’Ts of Self Harm

I found this years ago in a Facebook group and have always thought it quite brilliant, hence my reason for sharing it today:

The DOs and DON’Ts of Self Harm

SI Awareness

01. Don’t ask them why. If they want you to know why, they will tell you. Most of the time they don’t even know why.
02. Sometimes they just need to tell someone, because they fucking need to.
03. Never talk about him/her behind their back. They will find out and they will be pissed. They prefer you to speak directly to them.
04. If you ask them to never self-harm again, and they say “okay”, they’re lying.
05. Never ask them to never self-harm again.
06. Don’t try and understand why they do it. You’re wasting your time.
07. If you don’t know what to do, just ask them “Are you [insert appropriate form of harm here]? Do you need to talk about it?”
08. Get over your own insecurities about worrying if they’ll hate you for asking.
09. Asking shows concern. Not asking shows negligence and an “I really couldn’t care less” attitude.
10. Telling a teacher/parent/counsellor/other friend before talking to the person in question shows “I can’t be fucked working up the courage to ask them myself”. But it’s better than #09.
11. Offering suggestions of other means of coping is pointless.
12. Tell them that you’re there for them. No matter what. And you never judge. And you will always listen. And you will always just be there. And sometimes you never have to say a word at all. Sometimes they don’t want you to say anything.
13. It does not mean they love or enjoy pain.
14. It gives them the right to make fun of themselves/other self harmers.
15. Depending on the situation, it does not give you the right to.
16. Classifying them as “emo” only reduces yourself to an ill-informed bitch who believes you’re God’s gift.
17. It is not always a case of attention-seeking. A lot of the time it isn’t.
18. Self harm is a way of coping with emotions. While most people might cry and scream and rant and rage, self-harmers generally don’t express those sorts of emotions openly, and bottle them inside. The only way they know that works of releasing them is by inflicting pain on themselves. Hence the NOT ATTENTION SEEKING.
19. If they wanted attention they would go slit their wrists in the toilets at school and walk out with their clothes soaking in blood, collapse in the middle of the school grounds, and wail.
20. Other people self harm because they’re so emotionally numb on the inside, they need the pain to remind themselves that they’re alive.
21. Others hurt themselves because they believe they deserve it.
22. There are 39846324956234986487562387456238475123518746459865 other reasons for self harm.
23. There is not one direct cause. There is usually a trigger. A trigger may be a picture of a cut. That will get them thinking of cuts. That will get them into the mindset of cutting. And inevitably, they will want to cut.
24. Other triggers include any form of high negative emotion.
25. There is a difference between cutting for release and cutting for addiction.
26. Addiction-cutting is when you used to cut because you needed it, and now you cut because you can’t stop. You have no way of controlling the emotions without cutting. So you cut when you’re angry, sad, depressed, etc. It works. Temporarily. So when the same emotion comes up, they do it again. Only this time it doesn’t work as well. So they do it harder. And etc.
27. They know they shouldn’t do it, it’s no use telling them that.
28. Some of them like their scars, some of them hate them. Some are proud of them, some are ashamed. Just because one likes them and the other doesn’t, does not mean that the one who likes them is “okay” with what they do.
29. The need and want to self-harm rarely goes away.
30. Ask them questions about what they do. If they don’t want to talk about it – don’t push it. But if they do want to talk about it – keep asking questions. Don’t let them do all the talking. Ask questions. Questions are caring. Questions show them that you love them enough to want to know what they do, so you can understand and be there for them as best as you can.


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When Doctors Discriminate

“At least 14 studies have shown that patients with a serious mental illness receive worse medical care than “normal” people. Last year the World Health Organization called the stigma and discrimination endured by people with mental health conditions “a hidden human rights emergency.”
~ Juliann Garey, Aug 10/13 ~

Last week, Kristen from Pride in Madness wrote a post titled When Doctors Discriminate, in which she recounted some of the discrimination she has experienced from medical professionals. It was a post that grabbed me because, over the years, I have been continually shocked and dismayed by the level of discrimination that is shown by people who should know better.

It’s no secret that I’ve had “issues” with various mental health services over the years; “issues” that have caused me to foster a massive distrust of the industry and stopped me from seeking professional support.

What follows are just some of the discriminatory incidents that I’ve experienced from medical professionals:

  • On the 11th October 2007 I attempted suicide. Whilst lost in a delusional state I hiked nearly 50km without food or water from the Melbourne CBD to the Dandenong Rainforest because I believed that if I hung myself there I would save the universe from an apocalyptic event. Whilst I was doing this the police had begun to investigate me as a missing person. When they eventually located me they took me to a major Melbourne hospital in the back of a divvy van and refused to leave me on my own until the hospital staff had taken charge. Fully expecting to be hospitalized – given my mental state and obvious signs of bruising on my neck – I was stunned when the psychiatrist gave me three anti-depressants (no blister pack, just three white pills) and told me to go home because, in his words, “I would be fine”. I wasn’t.
  • Not long after this suicide attempt, I presented to the same hospital after a vicious act of self-harm. Whilst cleaning my wounds they treated me like I was a “naughty little boy” (I was 28) who should “know better”. I was then sent home with no follow-up from a psychiatrist.
  • In January 2008, whilst living homeless in Melbourne, I managed to get myself to a local Mental Health Service after a nasty period of self-harm. In floods of tears I was begging them to hospitalize me as I was terrified I would shortly attempt to take my own life. They refused to help me, informing me that they could only help people who were “a danger to other people, not themselves”, so sent me back to the park in which I was living. Less than twenty-four hours later I attempted suicide.
  • Whilst I was homeless, I was refused help from an NGO because I would not admit to being a drug addict. I wasn’t a drug addict, but they believed because I was homeless, and suffering from mental illness, I had to be a drug addict. Needless to say I was turned away and told to come back when I was willing to admit to my (non-existent) problems.
  • In late 2011 I went to see a psychiatrist to have my recently prescribed levels of lithium checked. I had been taking the drug for a couple of months after it had been prescribed by a different psychiatrist within the same organisation. In less than one hour, this new “psychiatrist” informed me that as a twelve-year old boy “I should have understand the complexities of my sister’s mental illness” and that “it was my fault I had allowed her illness to affect me the way it had”. He told me that “I did not deserve to have children”, that “there was no such thing as multiple diagnosis of mental illness”, that “there was no medication that could help me” and that “I was playacting mental illness in order to escape homelessness”. He immediately stopped my lithium dosage and, after reducing me to a trembling, shaking, crying mess, sent me on my way. I’ve refused to have any contact with psychiatrists or mental health services since this incident.

I strongly urge all of you to read Kristen’s original post and share your own stories of discrimination from medical professionals as, like her, I believe these are stories that need to be told.