I don’t take care of myself, that’s not news. It’s been that way for a long time although I am aware it has gotten a lot worse over the last couple of years. Not caring about yourself and self harm pretty much go hand in hand so I guess you could say that I haven’t taken care of myself for 18 years. What’s happening now is something different though. When I started self harming, I wasn’t thinking about death, I was thinking about coping. That changed and it became about pure destruction rather than a way of dealing with things. I used to eat healthily, actually cooking rather then putting a ready meal in the oven, I thought about my alcohol intake, got some exercise, even venturing to the local pool for a swim at times and I saw my GP when I needed to. I used to think about the little things – shaving my legs, exfoliating, moisturising, painting my nails – not anymore. It’s not even about ignoring these things, I go out of my way to destroy my body in any way I can. I survive mostly on junk food, shovelling food into my mouth like there’s no tomorrow. I ignore physical symptoms because I am hoping whatever it may be will just kill me. I don’t take my anticoagulants, praying instead that a blood clot will finish me off especially with the elevated risk of it occurring even if I do take the tablets. Despite being fully aware that I need a stronger prescription for my contact lenses, I continue to wear the ones I have because doing anything else comes far too close to taking care of myself. I ignore letters from the GP saying I need to have a blood test because of the quetapine I take. I’ve ignored so many letters about getting a smear test that they recently wrote to me saying that I could out (or something along those lines).
So why am I writing this now? Because today as I was eating my lunch, I lost part of a tooth. Most people would’ve called the dentist. I’m not one of those people. The last dentist appointment I had was in January, made by my mother who also drove me there so I couldn’t back out. The dentist (who is absolutely lovely and who I’ve known since I was a child) wanted to do some treatment and put in a filling but I couldn’t bear the thought of it. Not just because I’ve been terrified of dentists since the experience of braces and orthodontists during my teenage years but because, again, it is a positive thing, something that re-inforces the idea that I am actually worth looking after. So I lied, I explained I take blood thinners and that my INR, (the level that measures the thickness of your blood) was too high, leading to the risk of excessive bleeding. She did what I knew she would and explained she couldn’t treat me that day. So I left, promising her I’d come back when my INR was stable again. That was 8 months ago.
What do I do know?
6 months ago I had options; I had 3 ways of self harming and using one, two or mostly, all three of them was allowing me to function. 5 months ago two of those options were taken from me. It had been coming for a while but I still wasn’t prepared and when it happened it felt like my whole world had been turned upside down. I understand why the decisions were made, if I could have kept my self harm to cutting then the professionals would have been concerned but ultimately left me to it. I’ve been doing it for 18 years and I’ve always kept it under control. However when you start to self harm in ways that will ultimately kill you, they start to worry, especially when you are running a massive risk of internal bleeding. My GP made a decision to take me off the blood thinners I’d been taking for 4 years as apparently taking double or triple dose is not deemed a “good” thing. That was a massive blow as not only was the risk of internal bleeding eliminated, I now felt unable to turn to cutting as a form of self harm. Yes I’ve been cutting for 18 years but when I discovered the damage I could do if I cut while taking far too many antioagulants there was no turning back. Cutting now just makes me angry as I’m unable to cause as much bleeding as much as I know I can.
Since then I have been switched to a newer anticoagulant which does the same thing as the old one but does not require regular monitoring and isn’t affected by certain foods and drinks. Because of my habit of abusing said drugs my GP decided I would have to pick this new medication up every day and take the tablet in front of the Pharmacist. This was to be reviewed but seeing as at the momen I generally only end up taking it 3 times a week, she is not inclined to let me take it home. We are all certain that no matter when I am allowed the privilege of having my medication at home I will go back to abusing it, it’s unlikely the situation will change anytime soon.
I am now in a position where I feel like I only have one form of self harm to use but I’m actually not really even doing that. What has happened is that I am currently more suicidal than I have been for 5 years. Since February my mood has deteriorated as I have had no way of dealing with the need to hurt/punish myself. Because of this I am being forced to manage things I have spent 18 years running away from. This is having a negative impact on my work, friendships and family relationships. It’s also led to a return of bingeing as a form of punishment which doesn’t help anything at all.
I do not blame the professionals, not even for one second. They did the only thing they could do. I was puting my GP in a horrendous situation as if she continued to write prescriptions she was leaving me in a position where I could have a catastrophic bleed. If she stopped issuing the prescription she was leaving me open to a catastrophic clot. While I place the blame firmly on me and me only, the lack of self harm is killing me. It was letting me function, I was managing, I was coping. Now I am as far from that as it’s possible to be and it will kill me.