Acute Anticholinergic Syndrome?

I did some reading today on the possible effects of carbamazepine overdose.


http://www.inchem.org/documents/pims/pharm/pim100.htm#SectionTitle:9.1 Acute poisoning


Ingestion

                    The first signs of acute intoxication begin 1
                    to 3 hours after an overdose but may be delayed;
                    presenting symptoms usually include disturbances of
                    the central nervous system, and cardiovascular and,
                    less frequently, anticholinergic signs and symptoms.


I then checked wikipedia to find out what anticholinergic signs and symptoms might be when they're at home:

http://en.wikipedia.org/wiki/Anticholinergic




When a significant amount of an anticholinergic is taken into the body, a toxic reaction known as acute anticholinergic syndrome may result. 
 ...





Acute Anticholinergic Syndrome

Possible effects of anticholinergics include:

Ataxia; loss of coordination
Decreased mucus production in the nose and throat; consequent dry, sore throat
Xerostomia or dry-mouth with possible acceleration of dental caries
Cessation of perspiration; consequent decreased epidermal thermal dissipation leading to warm, blotchy, or red skin
Increased body temperature
Pupil dilation (mydriasis); consequent sensitivity to bright light (photophobia)
Loss of accommodation (loss of focusing ability, blurred vision — cycloplegia)
Double-vision (diplopia)
Increased heart rate (tachycardia)
Tendency to be easily startled
Urinary retention
Diminished bowel movement, sometimes ileus - (decreases motility via the vagus nerve)
Increased intraocular pressure; dangerous for people with narrow-angle glaucoma
Shaking


Possible effects in the central nervous system resemble those associated with delirium, and may include:

Confusion
Disorientation
Agitation
Euphoria or dysphoria
Respiratory depression
Memory problems[3]
Inability to concentrate
Wandering thoughts; inability to sustain a train of thought
Incoherent speech
Irritability
Mental confusion (brain fog)
Wakeful myoclonic jerking
Unusual sensitivity to sudden sounds
Illogical thinking
Photophobia
Visual disturbances

Periodic flashes of light
Periodic changes in visual field
Visual snow
Restricted or "tunnel vision"


Visual, auditory, or other sensory hallucinations[3]

Warping or waving of surfaces and edges
Textured surfaces
"Dancing" lines; "spiders", insects; form constants
Lifelike objects indistinguishable from reality
Hallucinated presence of people not actually there


Rarely: seizures, coma, and death
Orthostatic hypotension (sudden dropping of systolic blood pressure when standing up suddenly) and significantly increased risk of falls in the elderly population.[4]


Acute anticholinergic syndrome is completely reversible and subsides once all of the causative agent has been excreted.
A lot of this matches what I experienced, especially the CNS-related effects. I also clicked through to read up on ataxia, and found that it describes my problems moving/balancing well, especially the cerebellar ataxia, and it specifically states that 'most antiepileptic drugs have cerebellar ataxia as a possible adverse effect' - carbamazepine is an antiepileptic drug as well as a mood stabiliser.  

People with cerebellar ataxia may initially present with poor balance, which could be demonstrated as an inability to stand on one leg or perform tandem gait. As the condition progresses, walking is characterized by a widened base and high stepping, as well as staggering and lurching from side to side.[1] Turning is also problematic and could result in falls. As cerebellar ataxia becomes severe, great assistance and effort are needed in order to stand and walk.[1] Dysarthria, an impairment with articulation, may also be present and is characterized by "scanning" speech that consists of slower rate, irregular rhythm and variable volume.[1] There may also be slurring of speech, tremor of the voice and ataxic respiration. Cerebellar ataxia could result with incoordination of movement, particularly in the extremities. There is overshooting with finger to nose testing, and heel to shin testing; thus, dysmetria is evident.[1] Impairments with alternating movements (dysdiadochokinesia), as well as dysrhythmia, may also be displayed. There may also be tremor of the head and trunk (titubation) in individuals with cerebellar ataxia.[1]
Obviously, I am not a doctor, but I do intend to bring this up with my GP to see what she thinks, because it certainly sounds to me like it's a pretty likely explanation of what happened.  It also means that all the symptoms I presented whilst in their care were actually symptoms that were consistent with having taken a carbamazepine overdose. And that they discharged me (without any advice, and without putting any kind of safety net in place in case they were, y'know, wrong about their decision that I was just faking - they didn't say 'if xyz happens bring her back', or make sure she goes to see her doctor on monday or anything) whilst I was presenting symptoms of a syndrome that can - admittedly rarely according to wikipedia - lead to seizures, coma and death.

TL:DR

So, given it's a lot to ask people to read, I thought I should write a summary version. For the full version, start at Part 1.

I have probable bipolar disorder (certainly longstanding recurrent depression), and fibromyalgia, which means I am in continual pain to some degree or other, and it affects my ability to walk.  I tried to kill myself recently by overdosing on my mood stabilisers (I took 60 times my regular dose (100mg) of carbamazepine).  I changed my mind about 20 minutes after taking them and told a friend who rung an ambulance.  At hospital they did some tests, including a urine test that stated I had used cannabis in the past 4-5 hours when I hadn't.  My condition worsened while I was there and I lost the ability to walk or speak, I vomited, and I lost consciousness a lot.  Because my motor control and balance were basically gone I repeatedly hit my head (and other parts of my body), including faceplanting from my bed to the floor, and from standing (with assistance) to the floor, and smacking my head off walls.  As far as my friends are aware I was not checked for concussion at any point.  I don't remember much of the period I was in hospital for, bar snippets of memories here and there, but my friends were with me most of the time and have told me what happened.  The crisis team visited me twice and I was unresponsive/unable to communicate both times.  I became delusional and hallucinating (although I don't think anyone realized this at the time).  My friends left because in my confused state I asked them to (inasmuch as I was capable of communicating - very slurred words here and there, not proper sentences), having been told the hospital was admitting me.  The staff changed their mind and decided I was faking, said I was physically and psychologically fine, and tried to discharge me once my friends were gone. I was unable to leave by myself, they construed this as me refusing to leave and called the police.  They *then* rang my friend to come and get me, even though they'd said they would contact them before discharging me.  My friends took me home with the police's help in a riot van, whilst I was still unable to speak properly or walk, and was delusional.  The hospital provided no discharge information or advice or wheelchair, and didn't refer me on to anyone or arrange for anyone to contact me.  My friends looked after me whilst I was drifting in and out of consciousness for the next day, and had to help carry/support me to the bathroom and back because I was still unable to walk/control my body.  By the time I regained my faculties enough to be aware of what was going on I was badly bruised and injured in various ways, including a very bad black eye, and the second eye blacked up over the following day.  A doctor at the local surgery confirmed I was very probably concussed.  I recuperated at home with my friends' assistance, and no input from any medical professionals from this point on.

I intend to make a complaint about this.  Advice would be very welcome, especially from people with experience in making complaints against the NHS.  So far my intention is to speak to the community health council and mind and get advice off them, and request my medical records off the hospital. A friend has also suggested writing to my MP about it.  This happened in a hospital in Wales, if that affects anything.

Aftermath (Part 4)

To start from the beginning, see Part 1.

----

So. After trying to kill myself, going to hospital, vomiting, losing the ability to walk or speak, becoming delusional and hallucinating, hitting my head and other body parts repeatedly, discharged and sent home in a riot van whilst still delusional and unable to walk or speak, watched overnight by my terrified friends as I drifted in and out of consciousness... I woke up.

I was still unable to control my body properly, the world was spinning continually, and much much worse when I moved my head, I was nauseous (I was sick once during a trip to the toilet but I don't think I vomited again after that), I had very bad bruising on my arms and legs, the entire top half of my head was bruised and swollen, I had one very bad black eye (and the second one came up the next day), my jaw hurt when I opened it wide, one of my teeth was wobbly and numb/painful, my left shoulder felt wrenched, there was something wrong with my right leg, I couldn't straighten my legs properly to start with (due to sleeping in foetal position for so long I think), I had a headache and pain everywhere, pain in my ears, couldn't think clearly, felt stoned, was slurring very badly, and was exhausted, and I was confused.

My friends explained what had happened, and... I just felt even more confused, and upset and hurt and scared and angry.  I couldn't believe what had happened.  I don't expect great treatment from the hospital, they don't have a great reputation, but I couldn't believe they would do *that*.

I felt guilty for scaring and worrying all my friends, and for them having to go through all that because of me.

I asked my friends to see if I could see the doctor at my local surgery, because I wanted to know if the overdose would have done any long term damage, and how long I would be ill like I was, and whether I was concussed, and if my jaw and teeth were okay, whether I'd pulled anything in my shoulder, whether there was anything I should be doing, whether I could take my painkillers, when I should start taking my mood stabilisers again (if I should start taking my mood stabilisers again).  Because the hospital thought I was faking they didn't provide any discharge advice or information or refer me on anywhere.

My friends brought me some food and I gradually regained some appetite.  (Apparently they tried to get me to eat at one point in the night, they brought me KFC and managed with some effort to get me to understand that there was KFC, I slurred KFC back and indicated that I wanted some, and then... started chewing.  Just lay there and chewed. And they realized I was hallucinating eating the KFC, even though they hadn't actually given it to me yet.  I refused to sit up to take the KFC, because as far as I was concerned I was already eating it.  When they finally got me to take the bag I apparently put it over my head and went back to sleep.)  I drank some water too.  My coordination and balance improved gradually, and by mid afternoon I was able to walk to the bathroom and back just using my crutch and leaning on things - still very wobbly and having to move very slowly and carefully - if I moved fast at all I my body would overshoot massively in whatever direction I was moving in.  It was still a significant trip to get to the bathroom and back though.

The on-call doctor agreed to fit me in at the end of the day, at 4.50pm I think it was.  My friends tried to get hold of a wheelchair to try to get me there, but couldn't find one. My friends called a taxi to right outside my door, and with my crutch and support from my friends I managed to get into it, and made it through the drive by keeping my eyes closed (still dizzy and nauseous), it dropped us off right outside the surgery and with my friends supporting me, and my crutch, I made it to the seating area and lay down on the seats until we were called.

The doctor seemed nice, and he listened to our explanation of what had happened - largely from my friends, and I spoke when necessary, still very slurred, and keeping my eyes closed or fixed on the floor, because the world still span if I moved my head.  He checked my pulse and blood pressure and my eyes and said they were all normal.  He asked a little about why I'd done it, and how I felt now, whether I thought I was likely to do it again.  I think I said I wouldn't do it again in the next few days, because I didn't have the energy, anything else aside.  He said he would change my meds so I could only have a week's supply at a time, and I explained that I wouldn't try to kill myself again with the carbamazepine unless I had an awful lot more anyway, because I knew that much wouldn't kill me now, and I never wanted to go through that again.  I was trying to explain that I wasn't at risk of just doing it again, but I'm not sure it came out as reassuring as I intended somehow.  He said that it sounded very unusual, the way the hospital treated me, and I'm not sure whether he believed us or not.  He said he would look into it, and also that the crisis team weren't allowed to discharge me from their books without speaking to me, so they should get in touch with me at some point in the next day or two, and he took my friend's phone number, saying he would ring to check in on how I was and whether the crisis team had gotten in touch or not in a couple of days.

He said in all likelihood yes, I was concussed. He said my shoulder wasn't dislocated or fractured, it was just internal bruising.  I think he explained that the bruising on my forehead wouldn't colour up because the skin was too thin there, but yes, it was swollen.  He told me the tramadol would make me drowsy, and as I was still very drowsy that wouldn't be a good idea, but that I could maybe take it before bed. And to leave the carbamazepine until Thursday so the overdose would be out of my system, and then start back on it.  He told me that as it was more than 12 hours since the overdose I was out of the danger zone so I should be fine, and there shouldn't be any long term effects.  He also said that it *could* have killed me though, and I was very lucky it hadn't.

The crisis team have not got in touch. Nor has the doctor rung to check in on me.  No one has contacted me.

My friends stayed with me until bedtime on Monday, and then because I was able to get to the bathroom and back without their help now I was left to sleep alone overnight - I wasn't going to try again to kill myself right then so it was safe to do so.

Over the next week I rested a lot, and my symptoms gradually improved until my balance and motor control were back to normal and I regained the ability to walk.  I stopped slurring and feeling stoned, and the drowsiness wore off.  I continued to get tired very very easily and my balance and slurring were worse when I first got up and when I got very tired, for a while, but now they're all back to normal.  My bruises are healing up, my jaw feels normal, my tooth still feels funny but I think it's getting better.  I continued to have pain in my ears, and loud noises were painful for some time - possibly part of the balance problems were from hitting the side of my head and hurting my ears at some point? I apparently smacked my head hard from pretty much every angle at some point.  My ears still feel kinda funny but I think they're getting back to normal.  They were very painful when I was out in the cold a few days ago, but the weather has warmed up now.

As to my mood... to start with I was just focussing on getting better, getting back my ability to see properly and walk and talk, and that kind of overruled everything else.  I didn't feel glad to be alive, or angry to be alive. Just... overwhelmed and unable to think.  I was quite tearful, and cried quite often over the next few days even in front of people, which isn't like me.  On the whole I was relatively cheerful I think, making jokes about my condition and chatting to my friends. At least in part that was just because I didn't want to worry them any more, after everything they'd been through, I just wanted to be as much like me as I could, just normal okay me, but also I was *able* to be like that, because I wasn't thinking about the future or anything other than getting through the hours at that point.  As my faculties returned my mood got worse though.  I still didn't really wanted to be alive, still didn't see any way of things ever getting better, and now they were worse, and now the hospital was no longer an option, I could never go back there, whatever happened.  I became terrified of being sectioned - I never thought it would be pleasant, but now, after what had just happened, it was a petrifying thought.  I would be completely subject to the hospital staff and they could do anything, they could decide I was faking, they could leave me with no help when I was completely physically incapable, without painkillers when I was hurting. I couldn't trust them to treat me with even basic humanity.  And I felt so hurt and scared about what happened.  Kind of in shock over it.  Even though I don't remember half of it, it's been, well, kind of traumatic.  Physically and mentally.

I didn't feel like I could try to kill myself again any time soon, because I couldn't put my friends through that again.  But at the same time I had no hope that my life would ever get better.

I focussed on keeping busy - my friends were awesome and made sure I was rarely alone, people talked to me online and visited me pretty much every day.  People brought me food and toilet roll and things, because I wasn't capable of shopping or cooking for a while.  I got given a LOT of chocolate :P

And then my mood started to lift a little - still wobbly, I made the mistake of watching The Hours on sunday (on my own, no less) and cried hopeless on and off for hours afterwards.  On Monday my mood began to lift considerably and my insight came back, and I was able to have some hope and see that things can be better, and began to feel able to enjoy things a little again, and then by the evening I think I was mildly hypomanic - I was talking a lot and fast, and I was physically agitated and tapping a lot, and I had much more energy than usual, and I ignored my pain, and the fact that there are consequences for doing things and did way too much, physically speaking, and got in a silly mood and felt actually kind of happy for the first time in kind of a while.  It's a very very welcome break from the wanting to die, but I should remember that it's not me getting better, it's just my mood swinging the other way, which means it will swing back down again soon.  In the meantime I need to try to use it to try to achieve some things.

I have a load of financial concerns I need to try to sort. I need to arrange to see my regular doctor to discuss where we go from here.  I haven't started taking my mood stabilisers again - I was going to, and then when the day came I just... couldn't face it. I think if I go back on them I want to be on a higher dose, because that clearly wasn't helping enough, but I need to talk to my doctor before doing that.  Last time I saw her she told me I could take the dose down, but not up without talking to her - I'd reported that I was more stable than I'd been, and I think she thought that meant I was better, when really it was just that I wasn't as bad - still a long way off good.  I haven't seen her in months now though, because when I get bad I can't really do anything, so I don't feel up to making and keeping appointments.

And I want to make a complaint about my treatment.  So I need to go and see people to get advice on how to do it, and request my medical records, and write my complaint.  A friend has suggested writing to my MP as well.  My friends want to complain as well, they're livid about how I was treated. I don't know how it works, whether we all put one complaint it with multiple signatures at the bottom, or if I should make a separate complaint from them, or if just one of us should complain?  I need to get advice, really.  One friend has suggested talking to the Community Health Council, and another says I should talk to Mind, and/or CAB.  Unfortunately all these things scare me, I'm terrible at talking to strangers/making and keeping appointments to see people.  Right now I'm in a place where I could probably manage it, but 'cause I've been actually feeling good I've been focussing on that, reading things and spending time with friends, spent a little time on trying to sort my flat out a bit (it had gotten to a seriously disgusting state), took a load of garbage to the tip, that sort of thing. I need to get started on this though, I don't want to put it off and then end up not doing it.  It's really important to me that I follow this up, both for my sake and to try to stop this ever happening again to someone else.

I'm scared that I won't be believed, that they'll just wave my medical records and say the tests said I was fine, and claim I spoke to a psychiatrist during the period when none of my friends were there, and say I really was just faking, but I have to try.  Even if I *was* faking (which, y'know, I really wasn't) their behaviour was still unacceptable - if I was willing to fake being ill to the point of concussing myself by hitting my head on everything and somehow making myself vomit (even though it was in front of nurses so I clearly wasn't shoving my fingers down my throat) and pretending to not be able to walk or speak and weeing through my pants, then *surely* there'd have to be something pretty wrong with me, at least worth keeping me in for observation for a while?? And even if I was faking surely they should have checked me for concussion when I hit my head?

I just don't understand.

Anyway. That's what happened.  Sorry this has been so unbelievably long-winded, I know it's probably boring as fuck, but I wanted to write out exactly what happened in as much detail as I could.  Anything else aside I know if I just summarise it it just sounds unbelievable, so I worry that people will assume I'm skewing the facts.  I'm hoping if I explain in detail everything exactly as it happened people will see I'm not just misinterpreting or exaggerating.  And I needed to write this all out to get it straight in my head.

If you've actually read all this, then well done, and thank you :P

What my friends have told me happened (Part 3)

To start at the beginning, go to Part 1.

N and K's notes compiled, with further notes from me in brackets. The R referred to is me. Let's pretend it's short for Red, if you want something to call me. I think it's best I keep my real name off here.

Approx 2:45am sunday: R overdoses on mood stabilisers.

Approx 3:30/3:45am: R taken to A&E. 

4-4:30am: Blood tests and pressure taken, urine checked - all clear apparently. Positive for cannabis in urine.

[Googling says that kidney problems can cause false positives for cannabis - given my abdominal pain, and that it hurts when I pee, I'm wondering if this is a possible explanation?]

4:30am onwards: R falls unconscious, stating that she feels 'stoned'.

At some point, the first drip is torn out due to R flailing (not a great word for it, sorry).

[From talking to my friends I was apparently unaware I had a drip in much of the time, which combined with losing motor control and balance led to it getting pulled out when I moved around.]

7/8am: Shift change - night shift have been extremely helpful and friendly. Day shift seemed to simply treat R like a burden, and don't appear to know about her pre-existing conditions, despite it all being in her paperwork from when she came in.

8:30/9am: N told that because she is fine, R will have to leave at 9:30am/after Crisis team arrives and has spoken to her. 

9:30am: Crisis team arrive for the first time. R is unable to respond in any meaningful way, and after a failed attempt to leave the bed (due to N being told she had to leave) is left alone. She had hit her head numerous times by this point on the metal bars of the bed, and had added to these injuries with the wall and the floor. From where I was standing at the time, it appeared the nursing staff simply weren't expecting her to be unable to walk, despite being told that even on a good day R has trouble walking. Male nursing assistant appears to decide that she is faking at this point. She had been vomiting and unconscious [not at the same time, I was vomiting, and then later slipped in and out of consciousness, I believe, from what I've been told] until they tried to get her to move, at which point she barely responded and had to be lifted to be able to do *anything*. She was also making pained sounds and clutching at her abdomen. 

[From talking to N in person by this point I believe I had lost motor function and balance, hence repeatedly hitting my head when moving around in bed, and I kept trying to curl up on my side and smacking my head into the railings because of that. I was told to stand and attempted to comply and faceplanted directly into the floor from the bed, hitting my head hard on the floor, and when moving around with assistance I understand that I collided with walls and fell onto the floor repeatedly, due to my inability to control my limbs, and whatever was going on with my balance. I don't know when exactly but N mentioned that one of the staff dropped me once as well, when trying to support/carry me.  At no point that he is aware of did they check me for concussion despite hitting my head very hard repeatedly on hard surfaces.]

10amish: A&E is swapped back to its normal location. R is left alone with N to await the Crisis Teams next visit. The male nursing assistant convinces one of the Crisis Team that R is faking around this point as well, due to her 'looking out of the corner of her eyes to see if anyone was there'. 

[I was apparently still unable to communicate at the time of the second crisis team visit, I need to clarify whether this was because of my inability to speak or because I was unconscious this time.  I know at certain points my friends said they tried to wake me up and I was completely unresponsive.]

[This is embarrassing to relate, but hey, I don't really have much dignity left at this point, do I? Apparently at one point I needed the toilet, but as I was unable to walk they brought a commode over. I was unable to pull my pants down myself so they let me pee through them. I was left in my urine-soaked underwear.  I was still in them when I regained consciousness on Monday and was finally with it enough to realize they were not clean, and requested a friend get me some clean pants for me to change into. I asked N if I'd wet myself, due to the state of my pants, and he explained what had happened - he was present at the time, but didn't watch me actually pee at my request. And probably cause, y'know, I can't imagine he'd want to watch :P]

11am: N leaves, L takes over.

[Do not have L's notes yet]
[I'm not sure at what point K arrived, but she was definitely there from 1pm, as was L - these are K's notes from this point on]

1:00pm: R unconscious. Extremely difficult to rouse and when able to get a response limited speech capability words slurred and she seemed disoriented. Unable to walk or support herself upright in any fashion. Smacked head off of bed extremely hard as she tried to sit up at nurse instruction - significant bruising to face and she accidentally ripped her drip out [again] attempting to get up - she appeared unaware it had been there even after being informed several times by my self and nurses.  
       - R made continued references to severe pains and was clutching her abdomen. Asked doctor to examine. when he was shown that pain emanated 
from vaginal region he refused to look and summoned us back inside claiming it to be nothing "She seems to be pointing to her vagina so..."

[From discussion with L and K I believe this matches my memory from when I was in pain and became aware L and K were there and sent them away. Although obviously there weren't actually any hornby trains in reality.  All they could gather was that I didn't want them there, so they went into another room and then later left the hospital after having been assured that I was being admitted and told they would contact K in the morning before discharging me so she could come and get me.  I have a recent history of abdominal pain extending down to my vulva, which I believe K attempted to explain to the doctor after he refused to examine me, but he didn't pay any attention to this information.  Also, despite it being apparent I didn't want K and L to see me exposed, and them leaving the room for this reason, when he called them back in after having refused to examine me because I was 'pointing at my vagina' he had left me with my skirt pulled up around my waist and my lower half (with knickers on) exposed. Due to my lack of motor control I couldn't cover myself up, so K had to do it for me.]

[Having spoken to K and L the memory of being in a lot of pain and trying to ask for my painkillers matches a memory of theirs - they thought I was saying 'juice' over and over, but I was clearly frustrated when they tried to give me a drink, and kept saying no, and then repeating juice again. In fact I was trying to say 'drugs' but my ability to speak was so slurred and incoherent the word was unrecognisable.  At one point I apparently managed to say 'help me' and tried to get out of bed and with a lot of support headed towards the kitchen. In doing so I pulled my drip out (I didn't appear to be aware it was there) - I believe this was the second time, mentioned a little earlier in the notes - and was bleeding.  I assume I was trying to find my coat, which is where my tramadol was, seeing as no one could understand me and get me what I needed, and I was in severe pain.  A nurse turned up and I was returned to my bed. The nurse was apparently annoyed with me for having pulled the drip out again. L offered to help put the steri-strip/plaster (not sure which it was) where I was bleeding from where the drip was removed, and the nurse gave it to L and walked off, leaving her and K to deal with me. The drip was not put back in. K and L managed to guess at some point that I was asking for painkillers and asked the doctor for some for me and was refused.  They also asked if there was a reason I hadn't been sedated (given I kept injuring myself), and the doctor refused to even bother answering.]

       - Staff nurse (name unknown, bald with glasses) and another nurse (bleached blond hair) continually shouted at R and trying to discharge her when she was clearly unable to move.

       - Informed doctor of her conditions - Fibromyalgia and Bi-Polar Disorder as well as an allergy to wool. This was apparently the first time anyone had asked these questions nearly 12 hrs after her admittance to A&E. The doctor and previously several nurses had been informed that R lived alone.

[My conditions were definitely told to the staff when I arrived, but the people in charge of my care at this point were apparently completely unaware of them. K asked where my crutch was at one point, and the staff were unaware I had one, and asked why I needed it. K explained about the fibromyalgia, and they appeared entirely ignorant of this information and wrote it down, and K asked if they were then also unaware of my bipolar disorder, and they indicated they didn't know about that either, and wrote it down too. This was *after* they'd decided I was physically and psychologically fine and had attempted to discharge me.]

Eventually decision was made to admit her to the hospital overnight and we left upon R's request having been told we would be contacted when she was discharged in the morning so we could come collect her.

18:00: Recieve a phone call from staff nurse informing me that R was "refusing" to leave A&E and that the police had been called to forcibly remove her from hospital premises.

When I questioned why she was being discharged when we had been previously informed she was being admitted, I was informed "We don't have a reason to admit her there's nothing physically wrong with her. She's spoken to a psychiatrist and he says there's nothing psychologically wrong with her either so we can't admit her" I contacted L and left immediately to fetch R. 

[I was unable to speak or walk/control my body when K and L had left me, and was still unable to speak or walk/control my body when K and L returned, yet somehow in the intervening period they claimed I'd talked to a psychiatrist, and that I was physically and psychologically fine.]

      - I arrived at the hospital to find R curled in feotal position on the floor with all things removed from her cubicle due to her "throwing things around". Her arms were severely bruised and her facial bruise was showing at this point.

[My memories from when I believed I was on a school trip and trying to uncover a conspiracy and when my employees - the chocolate factory - were doing tests on me are evidently from this period - I was alone on a mattress on the floor during these memories, one of them with curtains around me that match those used to separate cubicles in a hospital, and my motor control and balance weren't working, nor was I able to speak properly.  I do not believe I was capable of throwing things around at this point, as I had no motor control - all I can think is that they must have misinterpreted me knocking things over due to my lack of control and balance. I was probably uncooperative at points though, due to the delusions and hallucinations I was suffering at this point - for example the chocolate factory memory they were clearly testing my heart, but as far as I was concerned I was being forcibly held down and undressed while people did tests on me I did not want.]

      - We were able to get R to the point she was upright by my self and L supporting her weight when the police arrived. They offered to drive her home. It took All four of us to get her into the riot van and back into her house. [The police got a wheelchair to get me to the van in, as the hospital staff had not provided one and I was clearly incapable of walking. The wheelchair had to stay at the hospital though, it was just loaned to get me to the van.] It was once R was in the van and the wheelchair was being returned that a conversation with one of the officers occured as follows:
             Officer: "Has she done this before?"
             Me: "What? Try to kill herself?"
             Officer: "I meant more the feigning inability to walk?"
This was the first I had heard officially that the doctors believed that R was putting on the issues above, though the use of the word "refusing" rather than "unable" had given me the impression that was the medical decision on my friend's condition. I was distinctly upset by this. 

[I remember parts of this, but I thought I was in an ambulance with a paramedic, I was just confused as to why the floor was wooden. I was apparently in fact on the floor in the back of the riot van with L and a policewoman.]

R's condition did not improve. In the end I was left having to stay and keep an eye on her overnight as well as help her to use the bathroom as her attempts to move resulted in another blow to the head. 

[K and her boyfriend R stayed overnight, my memory of being a Belgian minister was in fact from after I had gone to the toilet with her assistance - apparently my brain considering peeing an important political statement :P She remembers me making slurred references to 'the message' and collapsing on the floor when she was trying to get me back into bed.]

I am understandably concerned and angered by these events. A visit to her GP on the 18/6/2012 with a description of her symptoms as described above lead the GP to conclude she was suffering from the effects of a concussion.
This is a simple issue that should have been checked for as soon as her first head injury was sustained. But it was not. Instead the staff had already decided my friend was faking her illnesses when a simple check with either us or her
GP could have told them the severity of her mental and physical health problems, that this was not her first attempt at suicide, that she had recently been for an ultra sound for the pains she was reporting to the doctor that had worsened,
and that she has no history faking maladies inorder to gain hospital stays. 

[N - She had been asked by the night shift/the paramedics if she had tried to commit suicide before. She explained that she had considered it/had tried, but not by overdose. As far as I can tell, everyone from about 8am onward simply ignored the fact that all of it (except for asthma and the wool allergy, due to R forgetting) had already been written down]

Part 4. (The aftermath)

What I remember (Part 2)

To start at the beginning, go to Part 1.
----

It's hard to remember a lot. I know that I was in a low patch, I've read through my chat logs and I talked about struggling with suicidal feelings in my private blog and with a couple of friends in the days beforehand.

I felt like I'd been trying to endure this for so long, trying to just hold on and survive, and nothing got any better, and it would never get better. Even if the crazies abated some day they'd only come back.

In some ways I wasn't actually as bad as I get, but then I've always said it would be a mood like that that would kill me in the end.  In what I tend to think of as the worst patches I feel utterly desperate and awful and just getting through the seconds is so difficult, and I can't do things, can't interact with people, can't get up, get dressed, cook, wash, eat, I just lie there staring into space or I sit and click through tumblr and facebook until the day is gone and I can try to be unconscious again.  Sometimes I will hurt myself when I'm like that, although not much recently because in a strange way hurting myself sometimes kind of implies hope - it's something to do that might somehow make it better, but I feel like I've known for some time now that nothing can make it better, all I can do is endure because I'm not quite ready to die yet, and that's the only solution now.  Those times are horrible and very hard.

This time I was functioning, I was getting up and getting dressed and talking to people and having really kind of a nice enough time.  I could laugh at funny things and seem to be having a good time, and in some ways actually have a good time, although never really actually happy. It's just... fine.  And then I'll go home and it's like... that's it?  That's what this living thing is supposed to be? Just doing this forever.  This is it when it's *good*, when I'm not completely out of it and desperate and life feels unbearable.  This is what I'm supposed to be enduring all the bad for? And it just feels pointless.  And so I feel like I'm kind of fine, or maybe I should die.  What does it matter?  Nothing matters.  I had a friendly chatty conversation with a friend online the other day, sounding no doubt perfectly cheery and upbeat. At the same time I was getting together all the bits and pieces to cut myself.  Which I then did after he'd signed off.  Not badly, just little scratches.  Hard to explain why.  Just... I could read things or knit something or have a shower or slice myself up... what does it matter?

Friday I struggled with feeling like killing myself was the only option, and I was thinking about the fact that the future didn't seem to exist for me any more.  I didn't have any image of the future in my head beyond July - I don't mean in the way people often don't really know what they're doing, I mean it just didn't really seem to exist any more.  I tried thinking about christmas and it was the strangest feeling, it seemed like the oddest thing to think about because on some level I didn't really expect to be there.  I'm supposed to be trying to move to a different town in a few months, and I realized I didn't really think I was going to, that life didn't exist to me, but nor did my life here continue either.  It was just...blank, after July.  I hadn't consciously made any kind of decision to kill myself then, but I hadn't really been planning to live, either.  It was simultaneously kind of scary and kind of reassuring to realize.

I'd also had this recurrent thought lately about taking an overdose. I took mood stabilisers, one three times daily, and when I missed a dose by accident there seemed to be a sudden drop in mood the next day - hard to be sure whether the pattern was actually there or if my mood just fluctuated and I was seeing patterns because then it seems like you can control it.  Anyway.  So the association was that taking the pills makes me happier/less crazy, only they just didn't seem to work enough. So my brain felt like taking more should make me happier.  If one helps a little, then 10 or 20 should help more.  The frustration at not being better and enduring day after day made me impulsively want to take lots to see if I could get better quicker, sort of.  I knew rationally that this wasn't how it worked.  I used to work in pharmacy for fuck's sake, I do know that's not how it works.  But I still felt the urge to take them, and thought about maybe taking a small overdose, just 10 or 20, not enough to kill myself, just to do *something*.  I'd managed not to do it yet though, distracted myself with other things.

I talked to a friend about some of the crazy, and then went to bed.  The next day I woke up and was still in the same headspace. Still functioning as well though. There was a little local music festival thing I'd been intending to go to, so I figured I'd go to that and see if I could distract myself, or snap out of it. I went along and it was nice, I was with good friends, we had fun. I went to the pub and talked to people and had a perfectly pleasant night.  The end of the night came and we walked home, and I didn't want to be alone yet, so I asked my friend/fuck buddy if he fancied coming in for a bit - he said no, and that was okay, I hadn't really expected him to, but I'd asked just in case 'cause I didn't really want to be alone just yet.  I didn't think I was in some terrible headspace and was going to kill myself when I got in, I was, y'know, fine.  Just felt like having company a bit longer.

And then I got in and that same feeling of 'so this is it then. this is all living is' hit me. And I felt so tired of doing this day after day after day, of enduring it, when I had no hope, felt like I just couldn't keep doing this. My mood dropped like a rock.  I talked to a friend online, one that lives far away, for a little while, but I was very detached from everything and hopeless and I just kind of... gave up. I gathered all my pills and I had about 120.  I didn't decide 'this is it I'm going to kill myself'.  But I had to do something.  I couldn't pretend to be okay to my friend, I was too out of it and down for that, but I didn't want to tell him what I was planning on doing, obviously. So I just said I didn't want to talk any more and signed out of chat or blocked him (I can't remember which).  He rang a couple of times and texted to see if I was okay, but I didn't respond, just hid from my phone until it stopped making noise.

I popped out all my pills in lines on my laptop, 7 to a line, one block of lines either side of the mousepad. And I still wasn't exactly clear on what I was doing, and I got a glass of water, and I wasn't sure whether I was going to do it or not and then I was just taking pills and I just kind of... turned my brain off.  Refused to think about what I was doing, just did it.  Three or four pills at a time, working my way backwards through the lines.  I had to go back to the bathroom to refill my glass of water several times.  I got halfway through and then just stopped.  Couldn't quite face keeping going any more.

And then I kind of realized that all I had to do to die was... nothing.  Before I hadn't been quite ready to actively take the step to kill myself, living was the default.  And now dying was the default, and living would require the step to intervene.  And so I thought maybe I could die. That it wasn't taking an action. I just had to wait and then everything would stop and I wouldn't have to deal with any of this again.  It didn't even matter if this was the right decision or not, I couldn't possibly regret it, because I wouldn't exist, there would be no me to regret anything.  It couldn't possibly be the wrong thing to do.  I just had to wait.  If I changed my mind I could call an ambulance, and otherwise I just had to wait and everything would be okay.

I felt very alone, and I just wanted to not be alone while this happened, so I messaged a friend on facebook, someone I don't talk to very often, that I used to be closer to, and asked him if he could do me a favour and talk to me for a while. Tried to talk about inconsequential things.  I'd moved the rest of the pills into a glass so I could use my laptop more easily, and I took a few more while talking to him. I was feeling kind of stoned by this point and not thinking very clearly at all, and feeling lonely and unsure. I knew he'd been going through a bit of a bad time and I was feeling kind of connected to him for that reason, and through the blur I decided to ask him if he'd ever been happy, really properly happy - in my head he was kind of equivalent to me in that moment, if that makes any sense? And he said yes. And I asked if he'd ever known me to be happy, really properly happy? And he said yes. And I asked if he was sure, and he said yes.  And then I wasn't sure what to do any more.  And thought maybe I should give things another go just in case.  I wasn't exactly optimistic that they were going to get better, but I decided if I wasn't sure I shouldn't die - I could always do it another time if it turned out killing myself *was* the right call.

I thought about ringing 999 for an ambulance but I couldn't face it - I have phone phobia at the best of times, and that would have been a hard phonecall to make, so I figured I had to tell my friend and ask him to ring an ambulance for me.  But the conversation had moved on and I wasn't sure how to tell him. Saying 'I've taken an overdose' just seemed so melodramatic.  And I didn't want to interrupt when he was talking about other things.  I know, that sounds dumb, but that's how my brain works.  And I was worried about depressing him - y'know, telling someone you've just tried to kill yourself can be a bit of a downer, and I didn't want to make him feel bad or anything.  :headdesk: My brain, ladies and gents.  In the end I managed to do it though, I asked if he could maybe do me another favour, and explained that I'd taken an overdose but changed my mind and could he possibly call an ambulance for me? Sorry.

He immediately did so, and told me him and N, a mutual friend that he lives with, would come over too.  I was very calm at this point, and feeling pretty stoned and out of it.  It felt like I'd put something in motion and now I just had to go through with it, I wasn't really thinking or feeling much about the situation, I'd kind of disconnected.  I took the pills that were left and put them in the bathroom under something so my cat couldn't get to them, because it suddenly occurred to me my cat might try to eat them and die and that made me feel terrible.  I found some pants, because I hadn't been wearing any and figured the hospital might need to get at my stomach and I was in a dress and didn't want to flash everyone.  One of my friends from earlier came online and linked me to something relating to a conversation we'd been having earlier, just as the ambulance got there, and he's someone I would have trusted with the truth but there wasn't time to explain and I didn't want to just say 'sorry gtg ambulance is here' so I just said I'd read it later mebbe and that I had to go.  I was also worried about telling him or my other friend from earlier about it because I thought they might be confused because I'd seemed fine, or maybe feel guilty like they should have somehow known and stopped me, even though that's ridiculous.  *I* didn't know I was going to go and try to kill myself, how should they have?

I remember the paramedic and N coming into the flat and me worrying that my cat would escape and trying to say be careful, my cat mustn't escape, and trying to grab her, and then being told it was okay, my cat was fine, so I thought someone had got her, and I shut down my laptop and got my coat and my phone and my keys and my crutch, because these are the things I bring when I leave the house and I was on autopilot.  I remember the paramedic asking me what I took, and asking for the empty pill packets, and me giving them all the ones I could see, and they asked why I did it and I tried to explain that I just wanted it all to stop, that I hadn't been doing so well lately, but it was hard to explain, the words never sound like how I feel and I was feeling shut-in and ... shy? I guess? I find it very hard to talk about my crazies to doctors and such-like, especially when I'm in the thick of them.

I didn't see my other friend, although he was apparently there (the one who rang that ambulance for me), but I remember getting into the ambulance, and them asking if I wanted one of my friends to come with me and me nodding and reaching out for N, 'cause I was scared and didn't want to be alone.

I don't remember the ambulance journey or arriving at the hospital.

I remember being told to change into a backless hospital gown, and being put in a bed. My friend stayed with me and held my hand a lot.  He told me my cat had escaped, but my other friend was looking for her, and I was very anxious, because she's not been spayed and she was in heat.  N got a text not long after saying he'd got her and she was fine and back in the house so I stopped worrying about her.  A woman came and asked questions and wrote the answers down on a form.  She asked for my basic details - name address DOB etc., and about my diagnoses - I explained that I definitely had recurrent severe depression, possibly bipolar disorder - my GP was reluctant to diagnose bipolar herself, even though it sounded like it, so she'd referred me to the local mental health place and I'd been assessed by them and then referred on for a short course of CBT/problem-focussed counselling, but I was still on the waiting list for that (and had been for months), and as far as my GP knew no official diagnosis had been made yet, but she was treating me with mood stabilisers in the meantime, and they'd seemed to be helping.  I remember her asking how I was managing my bipolar disorder without any support from a psychiatrist/counselling/whatever and me saying 'um, not very well?' (or words to that effect). She asked about any other ailments I had, and I told her about the fibromyalgia, IBS and I think I mentioned the possible TMJ disorder.  She asked about what medications I was on, and I told her about the carbamazepine and tramadol.  I forgot to tell her about my recent possible asthma diagnosis, or that I'd taken ventolin earlier that day.  She asked about what I'd had to drink and I told her (one glass of wine and four pints of cider, although that was spread over more than 6 hours).  She asked about allergies and I said no, although technically I do but I was having trouble thinking very clearly, and I thought she meant was I allergic to any medication, and I'm not. I do have dust, pollen, cat and wool allergies, and I have food intolerances, but I didn't think to mention any of them.  She asked why I did it, and I can't remember the exact answer I gave, but essentially the same as to the paramedic I think, that I had been struggling lately and I just wanted it to stop, and then I wasn't sure any more so I figured if I wasn't sure I shouldn't, which is why I told my friend.  She asked if I'd ever self harmed or tried to kill myself before, and I said yes, that I'd self harmed with scalpel blades and by hitting myself and things, and that I'd tried to kill myself before but largely ineffectual half-arsed attempts while drunk - slitting my wrists, going into the sea at night. I sometimes sat on high places and thought about jumping but could never make myself do it. Once I stood in front of a lorry.  Once I slit my wrists sober.  I'd never taken an overdose before.  She may have asked other things, that's all I can think of.

She then took my pulse and blood pressure and hooked me up to sensors to check my heart.  I think she said they were all normal.  I went to the loo and they asked me to give a urine sample while I was there, which I did.  I was using my crutch and leaning on N's arm, and was feeling very stoned by this point.  I remember making a silly joke on the way back from the loo to N about how people pay good money to feel like this.  I didn't feel good, just stoned to fuck.

My memory gets very patchy from here.

I remember the woman coming back and telling me my urine tested positive for cannabis, which  meant I must have had cannabis in the last 4-5 hours, and me being very confused, because I hadn't had any cannabis in the past 4-5 hours.  I tried to explain this to the woman, and explained that I really would tell them if I had, that I *do* use cannabis sometimes, for pain relief largely, but I hadn't had any in quite some time.  The last time I could *possibly* have had any would have been a week prior at my birthday party, but I really didn't think I had - I had a lot to drink so I couldn't be entirely certain, but I really didn't think I had. And definitely not any that day.  I'm not sure that she believed me.  I tried to explain that I really would tell them if I had, that I wasn't ashamed about the fact that I use it sometimes, but, y'know, I hadn't! I said that I had been at this music festival thing about 6+ hours ago, but it was indoors so there weren't people smoking, the most I could possibly think of is that it was possible I'd walked past someone smoking some? But I didn't remember smelling any and was only outside very briefly, and she said that couldn't possibly account for the results.

I remember listening to the nurses talk a little way away on the ward and it sounded like they were talking french, and asking N if they were talking french, because it seemed very unlikely, but it really really sounded like french.  He said no, they were definitely not speaking french, and I said something to him in french, I think largely because I know he can't speak french, so it amuses me to talk french at him sometimes.  I can't remember what happened after that.

The next thing I remember is being sick a lot, the nurses gave me a little dish to vomit into, sort of kidney-shaped, and I was curled up round it in bed vomiting - not bringing an awful lot up I don't think, but I couldn't stop being sick and it was horrible.  I remember a nurse saying she could put a tube in, would I like that, and I didn't really understand what she meant, but if it would help then yes please.  Memory goes blank again after that.

I don't know the exact order of the memories from after this.  I vaguely remember someone sticking me with a needle, I think to take blood.  The staff up until this point had all treated me fine, I remember being surprised by how nice the first woman who took my details down had been, 'cause when I'd been in after self harming before or when I'd taken in friends who had self harmed I was used to the nurses and doctors generally being really unfriendly and disapproving. (I hadn't been in for myself in several years though.)  They weren't being all 'oh you poor dear' or anything, but they treated me respectfully and didn't make me feel despised or like I was wasting their time, and I really appreciated that.

My memories after that are mixed in with hallucinations and delusions, and the sensation of being very very out of it, my body didn't work and I couldn't talk - it took a ton of effort to get even a single word out and it came out so slurred people couldn't understand me - trying to communicate was immensely frustrating.

I will detail what happened from my point of view in the order I remember it, and then come back to explain what actually happened from what my friends have told me.  I thought many of these memories were dreams until I talked to people and realized that they were actually memories, I was just hallucinating and delusional at the time.

I remember having really bad pain in my abdomen extending down to my vulva - I've had pain here a lot recently, I've seen the doctor about it and had an ultrasound, we don't know what it is yet.  It could be an infection, I need to do a urine sample to find out.  Anyway, this was flaring really really badly, worse than it ever had before, I was in a lot of pain, and I was on a table surrounded by hornby trains, and I looked up to see my friends K and L.  K is pretty much my best friend, and L is a good friend that I consider family, she was my little sister's best friend growing up, but she ended up moving to my town and we've become good friends.  Because she's family though I feel funny about her seeing me when I'm in a bad way, I feel protective of her, she's kind of my little sister.  She's one of those people that looks after everyone around her, and it's important to me that I'm not another one of those people, that I'm someone she can turn to when *she* needs advice, not someone she has to look after. So when I looked up to see her there I was really really upset, I really didn't want her seeing me like that, especially as there was something particularly embarrassing about to happen, particularly undignified - I couldn't remember what, but from talking to friends the nurse was going to examine where I was hurting, which meant pulling my skirt up, and given the pain was extending into my vulva I may have thought my pants were going to come down as well.  I really really didn't want her to see me in that state and was really anxious that she not be there, and angry that N had called her when he should have known I wouldn't want her to see me like that.  I was also upset that K was there because I'd told him not to call her until the morning, I didn't want him waking her up in the middle of the night, and as far as I was aware it was still night.  I think I also didn't want her seeing me exposed to be examined, either. So I tried to explain I didn't want them there. I couldn't speak properly though, I was stuck behind thick fog, and no one seemed to understand what I was trying to say, and I got more and more upset, because it was very important they understand I didn't want them there.

I remember that I was on a school trip to Belgium and I was sat on a raised cushioned area on the floor, and there were curtains, and there was a conspiracy and I had to uncover it, I had to get behind the curtain to find out what they were hiding from us.  But my body didn't work - I tried to crawl towards the curtain, but whichever way I tried to move my body would massively overshoot and the world would tilt and I would slam into the ground or the wall, I couldn't make my arms and legs do as I told them to, I couldn't control where they went, and if I tried to compensate when they went too far I'd swing violently back the other way. I was determined to find out what they were hiding from us though, so I clumsily crawled my way across the floor, awkwardly smacking into the floor and the wall and trying to make my way along through the complete lack of motor control or balance.  People kept coming and dragging me back to the cushioned seating thing and then leaving again behind the curtain, and I had to start again.

I remember that I worked for a chocolate company, and it was the end of my shift and I'd called my dad to come and pick me up and take me home. However, just before he got there they insisted on doing more tests on me.  They kept doing this, and I felt that it was wrong, chocolate companies weren't supposed to do this to their employees, but I couldn't stop them.  I was upset though, because my dad was there to take me home, and he gets really mad if he gets there to pick me up and I'm not ready to go.  (This is true, from my teenage years, if I rang for a lift home from a friend's house or the pub I was supposed to be ready to leave when he got there, or he'd be angry at me for making him wait.)  They'd promised me they'd already done the last one and now they were doing more, they were putting sensors all over me again, and I was upset because dad was going to be mad, and they'd promised, they'd *promised* they were done, no more, and they insisted on undoing my top - I was wearing a halterneck dress - and pulling it down, exposing my breasts (in a bra) so they could put sensors on my chest, and I really didn't want them to because I didn't want to be exposed in front of my dad.  Again, my body didn't work, I couldn't control where my arms and legs went, and if I moved in one direction at all I would swing really hard that way, I couldn't stop it, so I couldn't stop them from undressing me and putting the sensors on, and I kept falling off the mattress (which was on the floor) and hitting my head, and couldn't sit up or even lie still, any time I moved I violently swung in that direction and couldn't stop it.  I just had this sense of how this was all so wrong, it shouldn't be allowed, someone should be stopping them, chocolate companies just aren't supposed to do this to their employees! I'd said no, I didn't want them to do this, over and over, but they just held me down and did it anyway. And fear, because my dad was going to be mad, and it wasn't my fault, and I kept trying to explain to him, they'd said it was done, no more tests, but I couldn't talk properly so I wasn't sure if he understood.

I remember at one point being in lots of pain (my abdomen again) and K and L were there, and I kept trying to explain I needed my painkillers, kept saying 'drugs' - I couldn't manage entire sentences, it was so hard to push a single word out, my mouth didn't work properly, no matter how hard I tried it still came out distorted and slurred, and they didn't understand what I wanted and kept offering me a drink and feeling so frustrated and upset because I really really hurt and needed pain relief and I couldn't make them understand, I was trying so hard to enunciate, to get it across, but it just didn't work.  I had my tramadol in my coat pocket, and I wanted them to bring me some.

I remember being sat in a wheelchair and given a bag to hold onto, and wrapping my arms around the bag and kinda cuddling it.

I remember being in an ambulance going home, only the ambulance had a wooden floor and I didn't understand why, and L was there, and a woman I thought was a paramedic, and I could hear K - I couldn't see anything because I had my eyes closed because everything was spinning. I remember the paramedic asking K if someone was going to stay with me, and K said yes, and I remember her asking L how she knew me, and her explaining she was my sister's best friend from school, and me and her were friends, but not, like, best buds or anything.  K had to run back to her house to get my keys, so we had to wait for her to get back, and then people helped me get into my flat.  My body didn't work, my balance and motor control were still fucked, so people were supporting me and I was trying really hard to aim for the door, whilst everything was spinning and moving and out of control, and I was swinging from side to side because my arms and legs didn't work and we managed to get me to the bed and I collapsed onto it.

I remember being a Belgian minister, and I had just done something of great political import, I had sent a message to the world (or at least Belgium) and it was hugely important and world-changing, and now I was dying - my arms and legs didn't work and I couldn't see properly, but I had done it, and now it was okay, I could die, the message had gotten out, people knew now, and that was all that mattered.  K was there and trying to get me back into bed, but it was so hard, I kept smacking into everything because I couldn't control my body, and it didn't matter, because I'd gotten the message out and that was all that mattered, I might as well die there on the floor.  She didn't seem to understand though, and kept trying to get me into bed as if it was important, and I kept trying to explain about the message, that so long as the message was out, it was okay, although I couldn't speak, so all I could get out was a slurred few word about the message. She kept saying 'what message? the *text* message?? WHAT MESSAGE?' and I couldn't understand why she didn't understand, and didn't know how to explain, because it was obvious, it was THE MESSAGE.  Her boyfriend R was there too.

After this the delusions end, I remember being in my flat and needing the loo, but my whole body didn't work, just like in the dreams, I couldn't control it, when I told any body part to move one way it would swing way too far, I had no control, and if I tried to compensate I'd swing completely the other way, I couldn't hold still or be steady at all, and my legs wouldn't support me.  K was trying to support me, but my entire body weight swinging from side to side meant I kept crashing into everything anyway. I tried to crawl instead of walking because walking was too hard, but obviously my body still didn't work, so it was a case of my whole body smacking into the floor this way and then throwing itself that way and back and forth and making very little progress. Eventually we made it to the bathroom (my bathroom is about two metres from the foot of my bed, I live in a tiny bedsit, but it took forever just to get that far) and I was trying to get up to the loo but my head kept smacking between the shower and the sink and the toilet, whichever way I tried to move I just kept faceplanting.  I remember trying to hold onto the loo seat to steady myself and swaying violently from side to side, completely unable to balance, and accidentally pulling the loo seat off (I have a raised toilet seat) and smacking into the floor of the shower again.  I have a vague memory of being proud of having managed to pull my pants down once I was on the toilet seat.  I didn't want K to look while I peed.  I think I fell off the loo at least once, although hopefully not, y'know, during.  I don't know if it was this visit or another time I remember after all that finding I couldn't actually pee, and telling Kit (very slurred, but able to get more words out than before) that this was embarrassing, after all that I couldn't pee, and finding it sort of funny in a ridiculous kind of way.  I remember vomiting into the sink whilst sat on the loo.  I don't remember the trip back to bed, other than the sense of being glad it was over, and that it had been this immensely difficult ordeal to do, and taken a long time, and oh gods I didn't want to do that again.

I woke up when L and N (they are a couple) arrived to take over from K, who'd been sat on the sofa while I slept. I couldn't get back to sleep once they'd gotten there because they kept talking to each other - quietly, but enough to keep me awake.  I hurt all over and felt nauseous and everything was spinning and my body still didn't work properly, so I lay there with my eyes shut for quite a long time.

At some point I started talking to N - I think L was sat in the garden at the time - and asked him what had happened, and he started telling me - I was confused and temporally disoriented when he said 'that was the first night' because I thought all that had happened last night, and it was now Sunday morning.  Apparently it was in fact now Monday morning - I'd basically missed an entire day.

He helped me to the loo and it was easier than it had been with K, but still difficult, my balance and motor control still weren't working properly, and I needed a lot of support, but it was an awful lot better than last time, and I was able to talk, just very slurred, and I still felt stoned and like I was trying to think through fog.  I had bad bruising on my arms and legs, especially on my elbow and knees, one of my teeth felt odd, numb and sore and wobbly, my jaw hurt and felt wrong when I opened it wide, my entire forehead and surrounding area hurt and felt bruised and swollen - it all felt very tight, and my left eye was swollen so the flesh above my eye impinged on my vision, kind of like I could see my own eyebrow.  When I looked in a mirror I found I had a nasty black eye, and my lip was split. (The next day my other eye bloomed into a black eye as well, both of them very impressive, very dark and stretching down a good inch or so in a stripe below as well as on my eyelid, and there was some visible bruising on my temples - my forehead and top of my head didn't change colour, but was swollen up.)  I couldn't seem to straighten my legs properly, my left shoulder felt wrenched, and there was something wrong with my right leg, although I can't remember what now.  I was nauseous and it flared up in waves, which I spent cuddling an empty washing up bowl, but I wasn't actually sick.

Over the course of that day I found out from N and L and then later from K what had happened in the period I couldn't remember.  He explained that the hospital had decided I was faking, and discharged me whilst I was still unable to speak or walk, and called the police to take me away.

In the next post I'll detail what happened in the parts I can't remember from everything N, L and K have told me - Part 3.

So I tried to kill myself (Part 1)

So I tried to kill myself about a week and a half ago. Again.  And I think I should talk about that.

This is partly because the way I was treated by the hospital terrified/angered/hurt the fuck out of me, and I want to tell people about it.  And partly I just think it would be helpful to be talking about this. And partly because I have been reading the madosphere for years and never really engaged with it, I feel like I know all these bloggers and none of them know me, and I see the support they all give each other and I kind of would like to be part of that.  So. Um.  Hi? I don't know if this will be helpful to anyone else, but given how helpful I've found other people's blogs about their crazies in making me feel less alone, maybe this will be of some use to someone somewhere.

So I guess you should have some background on who I am and that?  It's traditional to lay out all my labels and identities and diagnoses yadda yadda, isn't it?  Let's see... I'm a 27 year old cis white poly bi/pansexual kinky geeky atheist disabled sex-positive feminist female switch with fibromyalgia, IBS, possibly TMJ disorder,  trichotillomania, with either severe recurrent depression or bipolar disorder, with anxious/panic features, who was largely emotionally/verbally but also to a certain extent physically abused as a child. And I live in Wales. I've probably missed some.  Mostly I'm just me, though.

Obviously I'm going to stay anonymous on here, I don't want family or friends that I'm not close to finding this, and I don't know about legal ramifications for talking about this if I were to identify the hospital in question. If you want a name for me, call me Red.

I've had problems with depression literally as long as I can remember.  I remember thinking about suicide in first school.  It was a long time before it occurred to me it might be an actual thing, an illness, not just... y'know, me.  That was just how life was, how *I* was.  Sometimes I was okay and sometimes I would cry for hours for no particular reason and I hated myself and knew everything would always be terrible and I would always be alone.  Sometimes I was better than okay, I was AWESOME; I was special; I could enjoy and connect with the world in a way other people didn't seem to be able to do, I could feel this incredible joy in the tiniest things and kind of step beyond the boring every day life that everyone else seemed to live and see the world in a different way.  Although I also hated myself for how I was when I was like that 'cause I'd talk too much and too fast and be too silly and too hyper and talk about things people didn't want to hear and push jokes past the point where they were funny or break the social contract in some way or other, and so I was pathetic and annoying and who would ever want to be my friend?

Anyway. Talking about my childhood could take a very long time and I've a lot to get through, so I'll move on.  History of my crazies another time, perhaps.  Very very long story short I think I was ill pretty much my whole childhood, and I remember the first time I had a period of stability that lasted a few weeks I was 16 or 17, and I was amazed, I remember wondering if this was what it was like for other people, to go actual weeks without feeling terrible or hyper, to just be... okay.  Happy sometimes, sad other times, but just regular-sad, not overwhelming everything is terrible killing myself is the only answer kind of sad.  It was at the beginning of my first long term relationship. Since then I have had periods of relative stability on and off, and periods of being anything from mildly to very unwell.  I tried various antidepressants with little success, although moclobemide seemed to help some of the time.

I had a couple of years of stability recently, I believe in part because of taking tramadol on a regular basis for my fibromyalgia (it has some SSRI properties, which I didn't know when I was taking it) - when I came off the tramadol a little over a year ago I went suddenly and severely batshit.  I was hypomanic for about a month and then severely depressed after that, and then swung between the two states with very few stable patches in between, generally having around 3-5 days of hypomania followed by a week or two of depression, although it wasn't always that neat a pattern.  It has been an absolute bitch of a year, in various different ways. In no particular order, my boyfriend of around 4 years - with whom I was trying for a baby before the crazy kicked back in (that's why I came off the tramadol) and I had to stop, because I clearly wasn't mentally fit to be a mum - broke up with me, in part because of my physical and mental illnesses, and the trigger for finally ending it was something I did when hypomanic that upset him, I had an incredibly intense and messy relationship with my best friend that lead to me having to break off contact with him completely for about 6 months, I was fired from my job because I was too unwell to work, and thus also lost my career because I had to stop the training course I was doing, and also accept that my physical state had deteriorated to the point where I would never work full time again, nor even part time unless I had a very significant improvement in my condition or treatment thereof, I lost my income but was too ill to deal with applying for benefits, I accrued a large amount of debt because of having no income, and couldn't handle communicating with the debt collection agencies and had bailiffs coming round and at least one debt went to court in my absence and is now coming out of my benefits, and there are still debts accumulating massive interest on that I haven't been able to deal with, I couldn't afford to eat, and subsisted off an average of 400-800 calories a day for months, and started developing eating disordered behaviour/thought patterns pretty much as a result of that as far as I can tell (luckily I managed to kick that one after a few months), my GP agreed that I probably had bipolar disorder, and so I had to try to deal with accepting that, and thus the fact that this could stay with me my whole life, on and off, and also try to accept the fact that despite desperately desperately wanting children I probably shouldn't ever do so, because when I'm ill I'm completely incapable of being a mother - I can't look after myself, let alone someone else - and even if I have another long period of remission it could always come back (and also deal with my sisters and cousins and several friends all falling pregnant and having babies), I realized more fully than before that I was abused as a child, and have been trying to come to terms with that, I applied for benefits eventually with assistance from friends and was rejected for DLA and couldn't face the appeals and missed the deadline, I had lots of problems with my ESA, which wasn't paid for about 6 months despite me being eligible for it, and I've watched the government welfare reforms with increasing terror, and am still waiting to hear back from my medical assessment to find out whether I'm going to be found fit for work and have to appeal... I think there's more but that's most of the worst of it.

It's been a hell of a year.

I've been trying to focus on getting well, but it's been pretty fucking difficult.  Every time I feel like I start to make progress and maybe starting to sort my life out a little bit I end up having another bad patch not long after and any progress I made gets completely destroyed.  And my physical health makes dealing with my mental health even harder - even without bipolar disorder it's hard to handle being in continual pain, and all the other symptoms I get from my fibromyalgia.  Some days I can barely walk at all, even with two crutches. And I don't have any effective pain relief - I take tramadol but it has very little effect.  And I've been trying to deal with all this with no professional input bar my GP because services where I live in wales are massively over-subscribed and under-funded.  I've been on the waiting list to see a pain specialist for between 6-12 months now (can't remember exactly when I was referred, but it was last year some time), and I've been on the waiting list for counselling - just a crappy little 6-8 sessions of CBT/problem-focussed counselling/stress management type counselling for nearly 6 months I think now as well.  I don't have a CPN or access to the crisis team or a counsellor or a psychiatrist or anything.  I saw a rheumatologist once to get my fibromyalgia and IBS diagnoses, but he's 3 hours away so I can't see him ongoing.  (He was the second rheumatologist I saw, the first one was in my town, but he told me fibromyalgia doesn't really exist, and I also don't have it, it's all in my head, and there was no support he could offer me. I wrote a song about him. It's called 'cunt'.)  I've seen two physiotherapists, years ago, both of whom were completely useless and were far too overworked to give me any real care, who both seemed to think I just had a touch of backache that would get better if I exercised more.  I've not got a support worker, I haven't been assessed by occupational health or provided with any aids for walking or getting round my house - I bought my crutches and raised toilet seat myself in the end.  I asked my doctor when a friend told me these services existed (no one professional signposted me to them) and she told me I had to contact social services myself to get assessed, but cause of my phone phobia and fear of talking to strangers I couldn't do it.  I eventually found I could e-mail as a first step, so wrote to request assessment to see if I could get a support worker, and the e-mail I got back told me they could refer me to the team for helping people with managing their debts, and I didn't know how to explain that actually I needed more help than just that, and ended up just leaving it.  I'm really really not good at talking to strangers, especially about this stuff, and when it gets bad I just shutdown and get terrified of talking to anyone.  So I know some of the lack of support may be my own fault - if I was able to ring social services and explain what I need and ask for it then I might be able to get a support worker.  But the reason I need a support worker is in part to help with the ringing people to ask for help with what I need, because I can't do it!

Anyway. All this is by way of explaining that I haven't had such a great time of it lately. And whilst the most traumatic parts are past, I'm still dealing with all the fallout from it, and the depression is more pernicious in some ways than it used to be, because it has so many genuinely bad things to fuel it, I can't say it's just my brain lying to me, because there's truth wrapped up in a lot of it - I really *will* be in pain for the rest of my life most likely, I may not be able to work again, I will never have enough money to live the way I want to live or do many of the things I want to do, I may well never be able to raise a family, etc. etc.  Which makes the crazy parts harder to identify.  And rather than it just being a flare up that will pass, that I can deal with, it's started to feel like a marathon, an endurance test that's been going on and on and on, that will never let up, and so I just sometimes don't feel like I have the resources to fight it any more, and often that there's no point fighting it, that after a certain point it just becomes dumb, the sensible thing is just to give up, because it's never going to end, it's just enduring this forever.  I just feel so hopeless when it hits, and like I've been fighting this for so long and I can't do it any more.  I've felt like killing myself is the only option for a lot of the last year, but I haven't felt ready to do it just yet.  It's felt kind of inevitable though.

So I guess it's not that surprising that I ended up trying to kill myself a week and a half ago.  In some ways it feels like it came out of nowhere, nothing happened to trigger it, nothing went wrong, no bad news, no one hurt me, I went to a local music festival and then the pub and chatted to friends all night and laughed and joked and went home and swallowed 60 carbamazepine 100mg tablets.  In other ways it feels like this has been coming for a long time, and it had been getting closer over the past few weeks, for all I'm appearing to function more than I was, I've just sort of run out of hope and got too tired of fighting.  I know some of my friends were worried about me, I'd talked about struggling with suicidal feelings with a few of them, and although that's always been a feature of my depression I think people were aware it was worse this time.  But there wasn't really anything anyone can do.  No one can reach into my head and make it better.  People talked to me and spent time with me, listened to me when I talked about crazies, tactfully made sure I was taking my meds.  What else could they have done? I know the obvious answer is to say that I should have been sectioned if I was at risk, but it's a very hard call to make for your friend, especially given being sectioned is a deeply unpleasant experience by all accounts - it's not to make you well, it's just to put you in a place where you can't kill yourself - it often makes people *more* ill, not better, and it can have serious long term ramifications once it's on your file.  All that is irrelevant though, given there's basically no chance the doctors would have sectioned me.  Again, massively underfunded and oversubscribed.  I couldn't even get counselling, there's no way they'd section me unless they thought I was actually going to kill someone (else) as far as I can tell.  I saw the mental health team here once, years ago, a matter of days after I'd made a sober attempt to kill myself my slitting my wrists - it wasn't a planned and well executed attempt, it was an act of desperation, and I wasn't entirely sure if I was ready to die, but I wanted to get as close as I could and see if I could manage it.  I opened up something that sprayed blood, but didn't *spurt* so presumably wasn't an artery, and when a friend guessed what I was doing (they were tipped off by me suddenly becoming very calm when we'd been talking on the phone earlier and I'd been desperate and tearful beforehand) I admitted it and agreed to go to hospital.  But it was still, y'know, a suicide attempt.  And I was told that I wasn't ill enough for them to even offer me counselling, because I was seeking help, so I couldn't be that bad.  So just having suicidal thoughts really wouldn't have gotten me sectioned round here.  And given I've had suicidal thoughts since I was a child I doubt my friends really will have realized that I was at risk more than before. They're not professionals, they have no training in this shit, they're just good friends that care about me, some of whom have their own crazies so have some understanding of what I'm going through.

I know I probably don't sound too bad right now, I currently have more insight than I have in quite some time. It's only the last couple of days that I've felt like there is maybe even some tiny possibility that things might somehow be alright.  I'm mostly trying not to think about it, because I'm very very far from being sure things will be okay, and I'm scared that if I look at anything in my life straight on I will plummet again, but I'm managing to deal with the hours okay, and focus on here and now, and I have enough insight right now to know I don't always want to die, and that I have been happy before.  I'm not really certain of very much beyond that, and that happiness still seems inaccessible to me, but it's still vastly better than where I was.  Yesterday I actually had a nice day, I actually enjoyed things.  Still not that deep-down happiness, but closer to feeling actually happy than I have in a while.  Mind you, I also seemed to have tipped up into a minor hypomanic episode, I was talking a lot and fast and had far more energy than usual and ignored the pain to do things, ignored consequences/pacing (and have been in a ton of pain and very tired today as a result) and felt confident and personable and able to talk to strangers and stuff.  So probably not a sign of increased stability, but at least it's a let up in the wanting to die, which is very very welcome.  I'm not sure where I am today.  I've been a little physically agitated, tapping a bit, and I've written a lot, words are coming easily, which happens more often when I'm up, but I'm not euphoric and I don't think I was talking lots or especially fast.  I haven't had lots of physical energy, I'm exhausted and in pain from yesterday, but being able to write all this indicates more mental energy than usual.  So I guess probably very slightly up, but only a teeny bit.  I'm nowhere near the unpleasant highs where my brain is going too fast and I can't concentrate on anything or think and I'm talking too fast and too much and way too openly and impulsively and I'm continually tapping and twitching and want to do something but can't do anything and want to rip open my skin because I feel unbearably... something, I don't even know what, like I want to do something but it doesn't even exist, a feeling like hunger or thirst but I don't know what so I can't sate it, and I want to fuck, good god do I want to fuck, and I want to get my nipple pierced, and I want to make things and I want to cut my hair and I want to meet people and talk to everyone and do all the things and I can't do any of them I can't even finish a thought because it jumps to the next one and everything's disconnected and jerky and and and. Yeah.  There are degrees of hypomania that are genuinely enjoyable and useful, but it often tips over past that into a place that's as unpleasant as the downs, just in a completely different way.  And there are the mixed episodes.  Those are horrible and dangerous.  They're probably when I feel most *crazy*.

Anyway. Right now I'm about the closest I've been to stable in a little while, so I'm going to try to get down as much as I can about what happened. These are very long posts, I'm really no good at brevity, so I'll try to split them up into sections.  Next one is what I remember about the overdose and subsequent trip to hospital - Part 2.

Edit to add: I have written a summary version, given this has gotten so long, for people who don't fancy the 10,000+ words version. It is here.