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Mental Health Use this forum to share your mental health concerns and to seek advice.

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Stuff and stuff and stuff. - October 1st 2012, 09:24 AM

I'm really bad at being able to title my threads, sorry guys.

So anyway, it seems at the moment, the key difference between being sectioned and maintaining informal treatment is how I act. (Probably a relationship I should have picked up on sooner.)

I've been "high" (what my various professionals call "elevated") for about 3 weeks now I guess, possibly closer to 4, I haven't really been tracking too carefully. In that time my probation officer got concerned enough about the intensity of my mood to contact my team, who did a quick assessment and came to the same conclusion that a crisis doctor came to a few weeks back - I'm "elevated". I'm not sure if by that they mean hypomanic or manic, but rest assured, it's definitely one of the two.

Anyway, I got lucky. I stopped taking my medication a couple of weeks ago, and instead of sectioning me, my doctor simply changed it to PRN so that if I decide to start taking it again, I can. (I take quetiapine, when I take it.) The only reason why that option was picked was because I haven't done anything dangerous.

BUT.
(And this is genuinely a huge but.)

I have very intense desires to do what I recognise are very silly things. I'm currently on a good behaviour bond for six months, so being sectioned isn't the only thing at stake here. I recognise that I'm in a place where I feel like I'm basically invincible (and the evidence thus far agrees with that interpretation), but that doesn't stop me from being under all the regular laws and all the normal scrutiny of mental health.

I want to self-harm (for shits and giggles), I want to climb on roofs and dance around, I want to go running back and forth across the motorway, I want to set things on fire just to watch them burn, and I want to do any number of things that randomly pop into my head and seem like excellent ideas. Such as driving away in a courier's van that was left idling. I haven't DONE any of these things . . . and that's what this thread is about.

If you're a very impulsive person, who is even more impulsive when their mood is elevated in a clinically significant manner, and you have a tendency to do stuff that gets you in some sort of trouble - how do you maintain regular behaviour? What tools do you use? Because I have come the realisation that I'm walking a very thin line here, and I don't know what the tipping point could be.

I also have no desire to lose $20, as myself and my flatmate have a bet going where the next person to get hospitalised has to give the other $20.

So yeah, is there anybody with any constructive suggestions that may assist me to continue to behave normally? Please let me know.

Also please bear in mind that because I am quite a high-energy person, I'm already doing things like art, computer games, going for walks, exercising, housework, and reading. I don't need suggestions for distractions, I'm amazing at that, what I need is some tools to help convince myself - usually within ten minutes or so - that the impulsive ideas are not good ones and I should just stay at home, because that's usually where my good intentions fall to pieces - as soon as I walk out the front door.

Thanks in advance for any helpful posts.
   
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Re: Stuff and stuff and stuff. - October 1st 2012, 11:32 PM

Could you remind us of what your current treatment plan is (ex. medication and therapy), and how you feel about those two things in particular (vs. how you feel about being sectioned/involuntarily committed)?






   
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Re: Stuff and stuff and stuff. - October 2nd 2012, 12:21 AM

My current treatment plan is that I see a mental health nurse (who is my keyworker) on a weekly basis, and a psychiatrist as often as necessary. I've been seeing my psychiatrist about once a month at the moment.

I'm not engaged in any therapy as such at the moment, but I have done some individual DBT with a psychologist in the past, CBT a couple of times, blah blah blah. I'm well-versed in mindfulness but you sort of need to be able to slow yourself down to apply most of that.

My medication was 500mg quetiapine at night, I was advised to raise it to 600mg a night by the crisis team a while back, and that's when I stopped taking it pretty much. So my doctor made it PRN.

Yup . . . that's my current treatment plan.

I don't mind the appointments with my keyworker, but it feels a bit repetitive at the moment because I go over nearly exactly the same stuff with my probation officer earlier in the week. I'm still on weekly supervision appointments.

The medication, I'm happy to take it when I'm low, but I don't like taking it to bring me down - and nor, to my knowledge, does anybody else.

I don't want to be under an involuntary treatment order or in hospital because they always put me in a locked unit and I never have any leave, not even to hang out on the other wards. The hospital considers me an AWOL risk, a self-harm risk, and a violence risk . . . I'm listed as "high-risk" for basically all their red-light things and have been in seclusion before. So that's why I don't want to go to hospital.

That, and the fact that hospital is really, really boring at the best of times.

Also, as I said, I don't want to lose the $20 bet. And I don't want to be forced to take medications. So yeah - does that tell you what you wanted to know?
   
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Re: Stuff and stuff and stuff. - October 4th 2012, 06:50 AM

Maybe you could try something I find helpful;
I have a 'point of call' (well I have a few actually) but I use her when I'm having psychotic symptoms and if I need to try and gauge if something 'is a good idea'
Often I get thoughts/ideas/impulses at a ridiculous time of the night on walks or such, so depending on the when you'd be able to have that, you either dont allow yourself to do *it* until you've spoken to them, or when they say it's probably not a good idea to actually trust that judgement. In my mind the whole point is to get someone to be your judgement whilst you can't properly be.. I know I can generally come up with reasons FOR my 'fun' ideas.. Sometimes I am not sure if it's something that I NEED to use someone else to help me with and its not foolproof but I personally work with if it's not something I could quite happily admit to my Mum - but fill with whomever works for you, someone who cares, who you wouldn't want to worry, because you'll lose other 'benefits' like driving/freedom.. etc - then it's something that should be discussed.


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Re: Stuff and stuff and stuff. - October 10th 2012, 05:50 AM

Thank you for elaborating on all of that - it helps to get a better sense of where you're coming from! =)

I agree with the previous poster. Having someone you can "check in" with, to verify whether or not acting on your idea/impulse would be a good decision, might be a good addition to your treatment plan. Obviously, it has to be someone who isn't currently experiencing the same mental health issues that you are - talking to someone else who may be going through a manic phase could have the opposite effect and result in your receiving bad advice.

Other than that, it's up to you to weigh the pros and cons. That's not going to be the easiest thing to do when you're going through a manic phase, so creating a list with your mental health nurse, psychiatrist, and/or "accountabuddy" (your "accountability buddy," the person who will help you with decision-making) might be a good idea. You could keep that list with you at all times, to remind yourself of why you take medication even when you don't want to, why you don't give in to the urges (losing the $20 bet is just one of many good reasons), etc.






   
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