sleep

hey guys,

Thought that I would write this pots around sleep and the lack of it. This is very relevant for me at the moment as over the weekend I didn't sleep – finally slept last night after 4 nights.

For me sleep and I have always had a love hate relationship. I have had long periods where I have really struggled to have a “normal” sleeping pattern and almost became nocturnal at stages. When I was at Lavender slowly I managed to change it so that I slept at night. This, however, was probably because I felt safe there. One thing about me and sleep is the nightmares, and that why I need to feel safe somewhere to be able to sleep. This probably makes very little sense to a lot of people, but for those who it does – your not alone!!! feeling safe meant that I was able to let the nightmares happen (as they didn't stop) but be able to deal with them in a very different way and so able to go back to sleep. To some extent I have been able to do that here on the ward as well.

As my CPN has said about my whole relationship with sleep especially when I was in the flat and didn't feel safe, was that it wasn't that I couldn’t sleep it was that I was so scared of it that I fought it. As is probably quite obvious the reason that I was so anxious of it was because of the nightmares and how real that they feel. Although I get flashbacks and body memories a lot of the day too, I find night times worse, partly because its dark and so harder to ground myself, but if I am awake I can at least try and control what is going on, where as when I am asleep this is impossible. I think that this says a lot about me, and how I need to be so much in control of everything, because the thought of being out of control is another thing that really scares me. I also need to be able to rationalise everything and understand it, and nightmares by their nature are not easy to do this.

Anyway enough about me!

Insomnia termed as; inability to obtain sufficient sleep, especially when chronic; difficulty in falling or staying asleep;sleeplessness – by the dictonary .com )

There are many reasons that lead someone to have problems with sleep, I have explained mine, but anything from chronic pain, through depression and anxiety to serious physical illness'. But I will concentrate on depression and anxiety as these are the things that also have a huge impact on my sleep.

In general anxiety causes a difficulty in getting to sleep, because the mind has been unable to shut down due to worrying or other anxiety symptoms. I also find that ruminating also causes difficulty to get to sleep. This also happens when someone is stressed with work or family although this tends to be acute insomnia rather than chronic that can be found in serious anxiety disorders. Early wakening is a sign of depression. Of cause this is not the case in all people, and sleep is just one symptom of many in both these disorders. (or at least this is what I can find on Wiki and what I remember from the food and mood course that I ran!).

Well that a quick look into the reasoning for insomnia without going into loads of scientific detail -  I can't cope with that right now. And there is only so much by knowing about something that it will help....so what does help?

As the picture shows there is stuff that you can do. I know that it depends on person to person as I personally have my TV on as I find that the light and noise bring me back quicker from a nightmare, and my routine of getting up and having a ciggie as a way to bring my head away from what happened in it goes against everything in sleep hygiene but it works for me. These are just ideas, you have to find what’s right for you.

Sleep hygiene I think is something that is gone on about in mental health that I know that I stop listening! So I hope that this post helps you bring back ideas that might help you sleep better.

love 

Luce xxx

ps sorry that this isn't a great post this is what lack of sleep does to me!!!

Coping Stratagies

Hey Guys!

I am still in hospital, I am waiting for a placement at a group home. I am still having pretty bad days, which is why I am doing this particular post...a more positive one! After the last few posts that have been around my symptoms, I thought that I would write a post that is about my coping strategies and other ideas that people have tried.

Everyone has their own coping strategies to deal with stress, whether it is coming home after a hard day at work and having a glass of wine, or walking the dog to get out of the house as its stressing you out. People with mental health problems have to get their own coping strategies to deal with the different symptoms that they may have. This is no different from someone with a physical health problem doing what they need to take care of themselves! This is what coping strategies are for me, a way to keep myself safe and taking care of myself (although some of mine are quite maladaptive, but as I am trying to keep this post quite positive I wont go into those!)

I have learnt these from all over the place, from the behavioural therapies that I have done, and other therapy work, to friends both “real” and online.

With self harm there are a large number of websites that not only give information but also have alternatives to self harm such as the national self-harm network has a downloadable list, some might not be your thing, but others maybe worth a try. Although many of these don’t give the same release as self harm does (its been proven that it releases endorphins – the happy hormone – and that’s why many people continue to self harm), my reasons are in a previous post its also important for me to remind you that I no longer self harm when I am aware of what I am doing. The two that are meant to give the nearest to self harm are pinging an elastic band on your wrist or holding ice cubes in something. These don't leave determinant damage but seem to work in some self harmer. For me this doesn’t work and actually makes me want to self harm more, but one thing that does work for me if I ever get the urge to cut when I am mostly dissociating  (And this happens when I am dissociating as well but doesn’t work as well) is writing all over my arms what I feel about myself in red pen. But, you just have to try things and find out what works for you.

Dissociation also has many coping strategies, both to deal with the amnesia and DID that I talked about in my last post. They tend to be called grounding techniques and over the years I have learnt many, some work some don't but that’s different for different people. For example, me, I cant cope with anything that focuses on the body as this tends to freak me out rather than help me. People who have worked with me have used the senses in order to stay in the here and now. You can use any sense – sight, sound, smell, speech taste or touch – although I find when I am dissociating the first things to go are that my hearing and sight become “fuzzy”.  The idea of this is to having something so strong that it helps you stay in reality.

Ones that have really helped me is having something really smelly (hopefully a nice one!) that isn’t related to the trauma on a rag or something you can carry around in your pocket. I use obus oil (thank you Amy for giving me this idea!). This way that if you can feel yourself going anywhere you can smell this – even if it is a hundred times – while reminding yourself that you are in 2014 and that you are safe.

The other one that I have just started using is taste. When I was at Lavender Doge, one of the staff always said try chilli – although that never appealed to me, and it might look a bit weird carrying it around. I carry around chewing gum, as the strong mint taste helps. With this it needs to be a strong taste, otherwise it won't work. Also if i have someone with me when I start to go a cold water (it has to be cold) can help – also splashing cold or hot water works – and all this is to change the sensations and so that grounds you.

Although I have said sight doesn’t work for me when I am going into a dissociative state, it does when I am coming out of it, and one thing that my old psychologist and I used to do was pick 3 things in the room and then say 3 things about it. It may seem simple but I can tell you it is so difficult. Another one I have heard about is choosing a colour before hand and finding all the things in that room that are that colour.

Sound never really works for me, although music is important to me (see later), it doesn’t ground me in the ways that the others do. Like in the other senses, simple things are the best! Listen to what’s around you, can you hear cars outside? Or the birds singing? What's the quietest sound you can hear? Put your favourite song on your MP3 player or stereo and listen to ever lyric. I have to thank Fort Refuge website for this as was really struggling with how to use sounds.

With speech there are various things that you can say that will remind you that you are in the hear and now. One is you can repeat to yourself a mantra such as “I am Lucy and I am safe now, no one is going to hurt me” another or the date, prime minister etc. A friend of mine does mental arithmetic, or you could repeat the states of America (if you know them!). Its about using your brain in a way that won't let it switch off. I also find using these also takes you away from the trigger that s overwhelming you.

Now touch- this one I really struggle with, and I also know a lot of people who have had trauma that their body doesn't feel their own, and so this may not work. But then again, I also know that it really works for some people. A lot of it is mindfulness techniques, which I learnt a lot of when I was doing the Dialectical Behavioural Therapy (DBT) in Bangor. Simple things like feeling your feet on the floor and bum on seat, but really feel how your feet feel on the floor and how the seat feels against you.

One that I do is find a safe space in a room, for me this is a small area, and sit on the floor and remi
These are all simple things, but they need to be to be so that when you are in that state that you can remember what to do., especially if you are on your own.

OK, I will get onto the coping strategies that I use, I hope that this helps someone!

The biggest thing in my life (apart from my friends) is music. There is different ways that I use it. I use it to drown out the arguments between my alters and other voices that I have in my head such as the “ED Voice”, I constantly have my pod on in here and when I am out and when I am home (wherever that may be) I either have my music or TV on to try and help drown out these. When I am at home and all the voices I here are really loud I put on my iPod on with my ear phones. I know that people that hear voices as part of their psychosis music can be really important to drown out these. The music you listen to is also very important, it can change your mood, or …. how you are feeling. For example if I am feeling sad and weepy listening to one of my favourite songs Concrete Angel (by Martina McBride) can actually mean that I can let my feelings out. However if I was very angry and wanted to calm down, listening to Nirvana say isn’t going to help you calm down, its just like watching a particular film and how it makes you feel. I hope that you understand what I mean.

Another big one for me is walking. Its an exercise that I really enjoy and its a natural way of releasing endorphins and keeping yourself fit (after all your physical health impacts on your mental health just as it is the other way around), this is important especially if you are on particular psychiatric medication, as it also helps kick off your metabolism. I find walking so peaceful along the sea and it helps make me realise that my problems are just a small part of the world, even though they are currently a big part of me. I am very lucky living by the sea as the waves and smell is so relaxing. Another reason that I like walking is that it gives me time to think rather than just reacting and ending up in self destruct mode. I can try to rationalise things that don’t make sense originally and try to make sense of me and the world. I don’t always succeed in getting answers but I am one of those people who need to understand what is going on, and what has gone on and how it affects me now (without hopefully completely dissociating). I also found getting out of the flat when lived there helped make me feel more safe. For some reason being by the sea makes me feel so safe and know that no one will hurt me again, as I am stronger so wont let it happen again! Having written this I have realised how much walking means to me, rather than it just being a way to exercise (which I am slightly obsessed with) but a way to deal with issues in my head by giving me a quiet space to think things through without the fear of automatically going into self destruct mode!

The final one that I am going to explain (after all this is getting quite long!) is talking to people, whether you are talking to professionals about what is going on with you, or friends about their latest news. Connecting with people is so important. I know that when I get unwell one of the first things that happens is I start to isolate. I know for a lot of people the worse time is when the professionals aren't available, so whether its you call or text a friend, or even ring someone like the Samaritans or other helplines (see the Eastbourne Survivors website for a list of help, they also have a resources page for survivors). Isolating isn’t good, while it might feel the best thing to do, it just makes things 10 times worse – and that is from personal experience. I know that I find ringing helplines very difficult, and I am really lucky that I have really good friends, but some of the help is online or via text. Just reach out and not feel alone. Another way to do this is to go out. I know that my body and mind are screaming at me that this is the wrong thing to do, and it doesn’t always work, but being around strangers reminds you that you are not the only one around and that helps!

I really hope that this can help people.

Just keep Swimming!!!

Love
Luce xxx

Dissocation and me

Hey guys,

Once again I am sorry for not being around, I have been in hospital for the last month and only just got my laptop. This post is very relevant for me, as the main reason I am in hospital is because of my dissociation, and the risks involved in it. Looking back it seems that I haven't done a post just on my dissociation, although I know that I have mentioned it a lot throughout this blog!

According to Wiki  Dissociation means;

In Psychology, dissociation describes a wide array of experiences from mild detachment from immediate surroundings to more severe detachment from physical and emotional experience.

This means different things to different people. I think I gave the example before of driving somewhere familiar and not remembering the journey, this is dissociation, but a very mild form that many people do, and not a problem, you could be daydreaming and not realise the amount of time that has passed. For me I have a much more severe type of Dissociation.

I was going to try and explain the different parts, but here is wiki's explanation (much better than anything that I could do...)

More pathological dissociation involves dissociation disorders including dissociative fugue and depersonalization disorder with or without alterations in personal identity or sense of self. These alterations can include: a sense that self or the world is unreal (depersonalization and derealization); a loss of memory (amnesia); forgetting identity or assuming a new self (fugue); and fragmentation of identity or self into separate streams of consciousness Dissociation Identity Disorder formerly termed multiple personality disorder) and complex post traumatic stress disorder

(I know that this website should be taken with a pinch of salt, but its the best explanation online that I have found!)

Well enough about the different types in terms of definitions, and onto what this blog is really about – how it affects me (and other people).

I have two types of dissociation, the Amnesia and DID (dissociation Identity Disorder).

The amnesia means that I loose time, its a bit like the daydreaming idea, but a hell of a lot more severe. This is when I am most at risk, such as cutting and overdosing – which makes it so dangerous as I am not aware of what I am doing! This came about as a safety mechanism to deal with the difficult circumstances that I have been through, not just the sexual abuse etc, but also the emotional abuse that I suffered from my mum.  Back just before I came into hospital I took an overdose, this is quite unusual for me these days, I then came home a few days later dissociated in the shower and needed stitches, and was admitted at that point as this type of my dissociation was so bad that I couldn't guarantee my safety. This is just an example when my dissociation is bad, and how dangerous it becomes. I've not only OD'd/cut whilst in this sate, but I have found myself in random places like Brighton with no idea how I got there, without some detection (such as do I have a train ticket et). I have many triggers that can lead me to dissociate, but the big thing is that I get overwhelmed by whatever (such as flashbacks) and my brain decides to switch off for a bit. This all, obviously, freaks me out, I mean how would you feel if you suddenly realised that you were somewhere you didn't know and it was several hours later??? This has happened!

The other major dissociation problem I have (although this is not formally diagnosed yet) is Dissociative Identity Disorder, something that I have talked about a little bit in previous posts. The best way that I can describe this is, is a way a friend has that I'm a chocolate orange, I have loads of segments but I am also a whole, Or you can see this link to a YouTube video of a lecture. It is important to remember that this is very different to the delusions that can be a part of schizophrenia, and the symptoms of this are not schizophrenia, it is very different. It is part of my PTSD, This means that I have several alters that are there own separate identities, and come “out” at various times. Usually this happens when they are needed to protect me from either external or internal “stuff”, however this is not always the case, but they all have a purposes. Sometimes these are called personalities, hence the old name of multiple personality disorder, but I don’t think of them as these as that makes them somehow external to me, and they are just not, they are me just as much as I am them! Some people do not believe in this diagnosis, but I think it is just something that is very difficult to understand. The cause of this is widely known as severe trauma, such as the sexual ritualistic abuse that I suffered as a child.

I am going to try and write about a few of my main alters, you have to remember that they are different ages, have different likes and dislikes, and can be very different in attributes. I do not know all my alters, some of them stay in the background, and there must be a reason for this that I do not know yet, and just as some of them come to the fore, some of the others can take “background time”.

 I guess the first one to introduce you too is the first one that ever made contact with someone in the outside world. Rosie is 5, She is very disturbed and knows a lot about the SRA and so is also very very scared. I think her role is to feed “me” info as I am able to cope with it. She loves Disney, especially Finding Nemo and so loves my wrist tattoo (Just Keep Swimming), like any young child would. She can write in my diary, and it is quite obvious when she has (such as some of the others) because of the handwriting. She also has a soft toy that is an original Tigger (as opposed to the Disney one) and she takes it everywhere!

Rachael is the teenager of us, and like many teenagers she likes a strop!!! she is also the most self-destructive of us all. She is another one that likes to write, but she is very angry and takes it out on us. She is Emo and loves all the stuff associated with this. Her role is the anger, although she needs to learn to control this anger and direct it in healthy ways!

Sarah is mummy, she looks after us all. I don’t know much about her apart from she loves to hug anyone who is struggling, and especially the little ones (there are more than just Rosie).

Then there is me, Lou, I am 31 (as I am in chronological age). I am the host. I have grown up like anyone else, and been through everything, although I don’t remember it due to the amnesia dissociation. (which is where some of the others such as Rosie come in). I try and keep order in my head between the alters, and give them “time” if they need it, but try and control them as well (don’t always succeed with Rachael though!).

These are just a few of mine. I have no idea at the moment how many alters I have as I am very early in the recognition that this is me.

I hope that I have managed to explain dissociation, and especially how it affects me.

Lou.

P.S. Finally have got the PTSD as my primary diagnosis!!!! (although still havent got rid of my BPD one!)