Tuesday, 29 October 2013

My secret life as a self-harmer and would-be suicide

Self harm is a common type of externalisation for a number of depressive or personality disorders.  It is very common in young adults, less so at my age (47).

A few months ago I started self-harming.

I couldn't and still can't identify a causative event, and I've suffered from mental illness (borderline Personality Disorder, PTSD, Depression, Anxiety) since childhood, but in all that time I had never deliberately hurt myself.

The only thing I can It roughly coincided with when I started to abuse Valium in a serious way (I'm at 20 mg a day now , but tapering off with a doctor's help using smaller dose tablets). Unfortunately that's led to me using a lot of Kalms as well, which contain numerous herbal hypnotics and sedatives including Valerian extract, a well known addictive substance from the "Great Binge" era.

I started small, a few abrasions with a pumice stone, followed by dressing the wound and clearing up the mess, it felt like someone caring and apparently released endorphins, which is why, I suspect, it has now taken over my life.  I usually did it if I had had an argument with or felt belittled by my wife, or if there was shouting of any description, which messes badly with my PTSD.  Verbal and physical violence are the same thing to my fucked up brain.  It was, I realise also a symbolic way of hurting those that hurt me.  If asked why I injure myself, I would say "it's because no one else will let me".  My suicide attempts are, in the same way, redirected homicidal urges.  For example, if I kill myself, my kids still have one parent, but if I killed my spouse, they wouldn't have any, as I'd be imprisoned for 20 years or more and emerge an old man.  The ineluctable logic of suicide.  Protecting ones kids is a categorical imperative and BPD/PTSD amplifies this, in the form of heightened hyper-vigilance and the hiding or explaining away of symptoms or injuries.

At first it felt, as I said, like someone caring about my pain and inner turmoil when no-one external seemed to.  It also had the added benefit of diffusing suicidal feelings and relieving anxiety, although I have made three serious suicide attempts in the past two months, that's another story, and an extension of another form of self-harm, deliberate SSRI overdosing to induce mild serotonin syndrome, which enabled me to be "ill" and stay in bed.

I think it was the addictive effect of he endorphins are what got me in the end though, and I'm finding now that I self harm several times a day, in more and more extreme ways.  I'm addicted to hurting myself and growing increasingly tolerant.

I started deepening the abrasions and increasing the bleeding with my razor, then a hobby knife and now I routinely use the reciprocal saw tool on my trusty Gerber multi-tool to really get the claret flowing.  I use Mepore dressings but if I've really hacked away at myself I have to add tape of waterproof dressings over the top to stop blood seeping through my clothes.

For those of you that don't know, a reciprocal saw is one with two rows of teeth running in opposite directions:


It's very effective.

On ironing days (most of Saturday and Sunday), I use the iron to make very painful, slow healing burns that evolve into seeping, bloody lesions after a day of two.  I've even carved words and pictures into my skin with a large blunt paper clip which gives broader strokes than a sharp knife would.  I do it at work, on the commute, at home, even in shop toilets.

And to cap all, if a wound starts to heal, I don't seem to be able to resist attacking it again, so most cuts take many weeks to fade to ugly scars.

My wife gets very distressed by all this and until recently I was hiding them from my young kids by only making wounds where a t-shirt and shorts would cover them, but having been caught at it buy both of them now, I have stopped bothering with that.  I am using bio-oil on the scars to try and get them to fade but to be honest I'm just as likely to make a new hole over an old scar now and the oil makes the dressings fall off.

The psychiatric "profession" seem helpless to stem this new tide and I spend my life in constant physical pain as a result, every time I bump into something or hug my kids the odds are it presses on at least one deep wound and makes me shout out sometimes it hurts so much.   Lying in bed is torture. To get any relief I have to take such a mammoth cocktail of painkillers that I get an actual hangover the next morning, plus the painkillers become slightly less effective.  add to this the fact that since my last suicide bid NICE guidelines have me on fortnightly prescriptions, forcing me to eke out my meds.

It has left me isolated and in worse shape psychologically than ever.  I am so lonely and desperately want to die at this point.  I've looked on the Exit international website and the components of the suicide bag are so expensive they make your head spin.  I could put one together after hours with equipment in the lab here for free but then some poor PhD student or cleaner would have to deal with finding my corpse the next morning. More than anything the two things that have inhibited many suicide bids have been fear of failure (and ending up crippled or worse) and sympathy for the poor sod who has to clear it up.  I used to be the thought my kids, but somehow the thought of them living on without me doesn't fill me with such profound sadness any more.  Maybe my increasing age and thus proximity to natural mortality lessens that feeling, or maybe the Valium numbs it.

Oddly, I keep thinking about my next holiday and how I won't get a tan because I'm essentially a grotesque mass of scar tissue and too ashamed to uncover.  I might not even wear shorts next year as some of my wounds have been in the ankle area.  Ah the random processes of the sick mind.

Thursday, 3 October 2013

BPD very bad

Borderline Personality Disorder is Hell.  It really is.

Take today, I've been physically removed from the road in front of speeding traffic by a good Samaritan because I was in some kind of depersonalisation fugue, I've almost fallen down several escalators, I feel high but not in a good way and I've done so much self harm that my left arm looks like it's been in a garbage disposal unit.

Why is this happening now?

I could blame the Cambridge thing, or course, particularly the way Astra-Z continue to refuse to confirm or deny that we're a. going and b. when we're going IF we're going at all.

Uncertainty and instability are generally very bad things when you have BPD.

Nobody really understands BPD well enough to make that sort of causal link though.

It's actually much more distressing for my family than it is for me.  If I nod off in front of a tram again like the other day, and nobody is around, I'll just get killed and my problems will be over.

Trouble is, the affordable and/or free provision for BPD families is shit, with a 16-week waiting list and the private stuff comes in at £50/hr, well out of our reach.

Yesterday I spent the day with my head under the covers or in the bath room cutting myself, I've gone through over a hundred wound dressings in two weeks and the ones I have on desperately need changing as I can smell the yuckiness all the time and they itch like crazy.  I've graduated from simple pumice abrasions to knives, razors and hot irons too. A worrying development. :/

trouble is, I would cheerfully do that every day but I'm shit-scared of losing my job again.  I don't feel like I can go to the disability support people here as that was the start of the downward spiral last time that saw me booted out, an unfair dismissal I didn't have the emotional or financial resources to challenge and still don't.

the crisis access team at my local hospital are all very well but BPD isn't really druggable like common-or-garden depression and there's little they can actually do when I'm in acute crisis like now.