A Life Lost

I have written the below with consent from Stephens' mother:

This isn't my first time discussing the mental health services in our country, but sadly today I am not writing on my own behalf.

On Friday the 15th of January Stephen Byrne attended Beaumont A&E to seek medical assistance. He was 20, a devoted father and suicidal. A few days prior, he had attempted to hang himself multiple times while in police custody; at that time he was brought to the Mater but was released. Despite informing staff at Beaumont of his intent to commit suicide, he was discharged. The only help he was offered was that his file would be sent to his clinic in Ballymun.

On Tuesday the 19th of January Stephen went missing; his body was discovered two days later, on his daughter's second birthday. To date, nobody from the Ballymun clinic has made contact with Stephen's family.

As anyone with mental health difficulties knows, asking for help when you are at your lowest is incredibly difficult. It takes unbelievable strength to fight your own mind and reach out. This is especially true for young men, as historically our country has stigmatised those with mental illnesses as weak or failing in some way. Men are statistically less likely to seek treatment for mental health issues, but they are four times more likely to die by suicide then women. Yet, when a young man found the courage to walk into an A&E department he was turned away, with devastating consequences.

I know all too well the pain and desolation of reaching out when all you want to do is die, only to be dismissed and invalidated by the very people who are supposed to offer aid. It might sound histrionic to some, but they might as well help you to step onto the ledge.

After my last suicide attempt, as soon as I regained consciousness I was discharged from Beaumont A&E without ever speaking to a doctor, let alone a member of the psychiatric team. I know a young woman who just last week attempted suicide inside the hospital grounds, and was simply patched up and sent on her way. I know that there are many people with similar accounts, especially those with a history of self-harm or suicide attempts. This is because certain hospitals, as a result of overcrowding and staff shortages, have a policy whereby patients who present more than a handful of times with self-inflicted injuries, including suicide attempts, are no longer referred to the psychiatric team for assessment. We are seen as a waste of resources.

This is not just a local issue, across the nation there are thousands of people waiting for referrals, many of whom will have to travel for hours for an appointment as a result of hospital closures. In some areas the wait for a psychology referral is two years. In 2014 nearly 3000 children and adolescents were on waiting lists for psychiatric referrals and children are routinely admitted to adult psychiatric units.

As a country we are finally starting to break the draconian cycle of shame and secrecy that surrounds mental illness, but our mental health service remains inadequate, underdeveloped and underfunded. The government and politicians are quick to promise change and reforms, but while we wait for them to turn words into actions more and more lives will be lost. Sadly any improvements will be too late for Stephen, his family and his little girl Ava.

Stephen Byrne asked for help and he was rejected; someone decided he was not important enough for their time, their care or their compassion. At what point does someones life become dispensable? Who are we supposed to turn to if our own healthcare system deems us unworthy? They tell people suffering from mental health difficulties to ‘speak up’; to talk to a professional; to not suffer in silence. They ask for our trust, and then break it. Ask yourself, if you were living in hell; if you were in so much pain that you would take your own life to escape it, would you put your survival in the hands of an institution that will likely make your life even more unbearable?

Treatment

I was discharged from hospital at the end of September 2014, after 8 weeks. During my stay, I had discovered the addictive high of starvation, self harmed repeatedly, and attempted suicide. At times my despair reached such devastating levels that I took to hiding in the tiny wardrobe in my room; this happened so often the consultant had to issue a note to the ward staff that I was allowed to use the wardrobe to manage my distress. At one point he suggested I purchase a cape, to offer comfort when I was out of my room; thankfully I had just enough sanity left to decline the recommendation. Sobbing in wardrobes was one thing, creeping around a psychiatric wars in a hooded cape was a bit to Phantom of the Opera for me.

When I was discharged, I was not 'cured'. My depression hadn't lifted and my eating disorder was stronger than ever; but as is often the case with BPD patients, they simply ran out of patience and solutions to my problems. In my experience there are two reasons why this happens. One is that the doctors and nurses begin to suspect you are lying about, or exaggerating your symptoms. The idea that lying is a characteristic of BPD is not universally accepted by professionals, and it is my biggest problem with my diagnosis. I have never exaggerated about my emotional state, thoughts or destructive urges. In fact the only time I have lied about my depression, is when I want to leave A&E and avoid a psychiatry referral. I have lied because I know the nurse sitting opposite me thinks I am a nuisance; or to stay out of hospital. Certainly not to seek attention or acquire a ticket to a mental hospital. Disclaimer: when it comes to my ED, I lie more than a banker at a tribunal. More on that later.

I returned home, back to the very kind and tolerant embrace of my local mental health team. Over the next few months I attended a day hospital as an outpatient, ended up in A&E six times for serious self harm injuries and more suicide attempts. I barely slept, barely ate...time kept moving but I remained rooted in the same painful spot. Large portions of my life during that time are lost to me, perhaps because I didn't have a life to remember, I just existed. Moving reluctantly from one day to the next with no destination. The only thing I had in my life that I could cling to was my new friend, restriction. That's what I remember most from that time, restricting all day until my boyfriend came home, and then throwing up after dinner. I structured my days around what I could eat, what I would purge and perfecting the art of lying so that nobody knew the full extent of the problem. Because it wasn't a problem, it was the only thing that got me through the day. If it wasn't for my eating disorder I would have been dead already. It was the only thing I had that brought me any peace, and I felt fiercely resentful of all attempts to take it from me. As I've said before, it became my best friend.

Sure my new BFF came with some downsides; I was cold all day, everyday. My joints ached, my skin and hair was dry and my gums throbbed from all of the acid. Then my white blood cells started dropping, and dropping and dropping...when it was decided that my immune system was compromised, my doctor took charge. I was once again referred for treatment of my eating disorder, but this time it was to a private residential facility.

I was, I am.

Before I delve into the next part of my story, I wanted to give you more of an insight into the ball of neuroses that is my mind. But I wanted to do so with as much honesty as possible; no re-written sentences and deleted words. During one of my sojourns in a psychiatric facility, I did a stream of consciousness writing exercise. We were asked to write two pieces; the first as the person we were before our current mental health difficulties took hold, and the second as the person we were in that moment. I pulled the two pages out recently for the first time since I wrote them, and my beliefs about who I am have changed very little since that day. So I am going to share them with you, in the hope that you might better understand how I ended up where I did; or that you might see something of yourself in it and know you aren't alone in your thoughts. Bear in mind that I wrote this without thinking, so forgive me for the poor quality.

Then and Gone

I am a quiet, introverted girl who enjoys the simple things in life. I love curling up with a book. I like clean bed sheets and hot showers. I like holding my boyfriends warm hand and his lips on mine. I like talking to my sister and my dad, even though they are far away sometimes. I love crisp Autumn evenings and pumpkin carving. I love cold Winter days and bright Christmas lights. I love deeply and openly and I am not afraid to trust my heart. I educate myself in my spare time to exercise my brain. I like to cook and delight in food; a cold glass of rosé wine with a friend over a trivial joke or a deep conversation. I care about others and can put their needs ahead of my own. I laugh often. I want to see my friends. I listen to music. I love to watch movies for hours and discuss them at length. I make jokes, I work hard and am happy making my house a home. I like walking in the evening and then cosying up on the couch. I am friendly and can talk to others, and even though I'm weird, people like me. I have had some bad times in life but I have fought back and I am winning.

Now

I was born to parents who hated each other for most of my life. My mother tried to leave me when I was one. My father left when I was seven and then I became the hated one; the symbol of all that was wrong in my mothers life. She remarried when I was e;even and he didn't want me either because I wasn't perfect. At school I was the freak, at home I was the unwanted and in my head I became the ugly one. At eighteen my mother and sister left me and I was alone. At eighteen I tried to kill myself for the first time and I was sad when I failed. I have never been enough for my parents, I needed to be replaced with others. I have hated myself for as long as I can remember. I am lost, broken, disgusting. I am damaged goods. I have been beaten by woman and man for my crimes. I hurt people. My life is a series of failures with no end. I cannot remember what love is. I find no pleasure in life. I remain only to not hurt the few who still love me, but I am unworthy of their love. I am a waste of space, I am destined to die and I despise myself. It is all my fault.


When I had to read them out, I cried for the person I had lost. Grieved for her. I no longer mourn who I used to be, I have long since accepted that the old me is gone. Which is probably sadder than anything else I have written.

Anorexia

In June 2014 I tried to hang myself; the depression, self harm and constant purging had become too much for me to bear. I have written about that attempt before, so I won't go into it again. Eight weeks later I was admitted to a psychiatric hospital, for treatment of depression and an eating disorder. However as I was a danger to myself and at risk of self harm I could not be placed on the ED ward. Instead I was on a general ward, and other than a handful of meetings with the incompetent nurse who rang the ED programme, left to my own devices with regards to what I ate.

Restricted to the ward, with all sharp objects out of reach, I threw myself at the mercy of my eating disorder. The despair had eaten away at me, I was a shell of a person. I felt like I was walking around with a black hole in my chest, that devoured all the light from the world. MY mind was always racing, from one self-abasing thought to the next, faster than I could blink. I would have done anything to stop the pain, even if it was just for a minute. The part of me that belonged to the ED offered up a solution. If you loose weight, you won't be so worthless. Worthless, and fat and repugnant. If you skip that meal, it will be quiet in your head for five minutes. The hunger pains took the edge off my self harm cravings. Skipping meals and secretly vomiting made me feel like I was taking some control nack from the doctors and nurses.

I started to loose weight, but it wasn't enough for that voice. Every time they weighed me it would whisper, 'So close, just a few more and it will stop'. The truth is, that goal weight will always be just out of reach. Because you can always try harder; because you ate that piece of toast on Tuesday; because you just have to look in the mirror to see that you're still fat.

The more weight you loose, the more behaviours you engage in, the stronger the eating disorder gets. It's like a leech, draining your body to feed itself. While you waste away inside, it thrives. I could no longer look directly at myself in the mirror, or look down in the shower. The sight of my stomach or thighs made me want to tear into my flesh, to punish my weakness. I stopped eating altogether for a few days, because I knew that I could. The less I ate and weighed, the more I hated myself. I think most people have been self-critical, more than once, and for some people it could be a regular occurrence. I don't think I've met anyone who thinks they look perfect all the time; I mean rarely anyone looks good swimming underwater, except that Nirvana baby. But for me, I don't even have to be looking at myself to be critical. I just need to be awake, and even then, I regularly dream about how grotesque I am. Right now, as I'm typing, that little voice is whispering to me about how doughy my thighs feel when my legs are crossed. And how rounded my wrists look, and my pudgy fingers. I'll stop there, but you get the point. It never stops, not even when I get so hungry I can barely stand. But it gets quieter, when I do what it says.

I said before that one of the reasons I started restricting was because it gave me a sense of control when I felt so powerless. In reality, the eating disorder had all of the power. It was stronger than me, that little part of me buried under all that shit and hurt, and if I'm honest, I didn't but up much of a fight. Because there was one other reason to give in, the distant hope that if you push it enough, your body will perish.

Don't Leave Me

I attended the day hospital for six weeks in 2004, attending the same groups and covering the same topics as before. While the day hospital gave structure and routine, I came out feeling just as lost and directionless. I returned to work, took a room with a family my dad knew and attended saw my psychiatrist monthly. The appointments were just 15 minutes long and served only to review my medication, and check the box next to 'No suicidal intent'. Still, I took my pills and tried my best to get on with daily life, fake it 'till you make it. Over the years I have spent long periods pretended to be happy; smiled when I wanted to cry; laughed when I was picturing razors and rivers of blood; kissed when I felt dead inside. I worked so hard at faking it that sometimes I can't take the mask off, sliding it into place is as natural to me as breathing. Not once has faking it improved my mood(despite what countless therapists have said), but it makes other people feel better. If you know me, you've probably only seen my real expression because I've had way too much to drink, or you've had the joy of bringing me to or from A&E. Other than that, what you're seeing is probably an act.

Between 2004 and 2014 I continued to battle depression and self harm. I have no idea how many times I had to go to hospital for stitches over the course of those ten years; how many psychiatrists I saw; how many therapists I spoke to; how many suicide attempts I made. If someone else told me that they couldn't count all the times they tried to end their life, my heart would break for them. But the rules are different for me. On my good days, if I think about it, I chastise myself for being such a nuisance. On my bad days, I berate myself for being so utterly useless, for failing so many times.

I had periods of being 'well', months where I was not self harming or in need of medication. But self harm wasn't the only aspect of my personality that was problematic. I frequently drank until I passed out; I racked up mountains of debt through impulse spending; I hurt people I loved and I allowed others to hurt me. I had no control over my emotions, I could go from one extreme to the other in minutes. Nothing was ever bad, it was terrible; I wasn't just happy, I was delirious. Everything I felt, I felt it with an intensity that never matched the situation. I didn't just love you, I loved you and would die if you left me. And I mean that literally. I don't remember ever saying 'If you go I will kill myself', although it's possible I did, but I know that it was definitely implied on multiple occasions. I know how awful that sounds, and there is no justification for such blatant emotional blackmail. My fear of losing the one person who I couldn't live without far outweighed my morals. That would be yet another characteristic of BPD - tendency to form intense and unstable interpersonal relationships.

If you grow up in an environment where love is not always given, or is expressed in negative ways, the one thing you want most in the world is to be loved unconditionally. All you want is for someone to choose to love you, to fill that need inside to be accepted and wanted. As a child I often felt there was something wrong with me, that when bad things happened it was my fault, always. I remember being 7 or 8, sitting at the top of the stairs one night listening to the noise below, and feeling so very cold and unwanted. Once that feeling takes hold, that shard of icy doubt in your heart, it won't let go. We learn to love by being loved, and if your own parents don't love you, there is no way you can love yourself. To this day, age 30, I still can't name one thing I like about myself, let alone love.

So when someone comes along and loves you, not because they have to, but because they want to, it's terrifying. Yes, terrifying. Imagine yourself balanced on a tight rope, arms outstretched, high above the ground. You're halfway across and the air is still, the only sound is your own heartbeat. You're smiling, you know this is your moment to dazzle the world below. You slowly lift your right leg up and forward, and as you lower it back down there is a sudden gust of wind. You wobble, desperately trying to right yourself. Your arms are stiff, moving up and down to counter the motion of the rope. The rope stills, your arms once again stretched out straight on either side, the terror subsides. You mentally shake it off, maybe laugh at yourself to dispel any lingering fear. You refocus on the rope, on that right leg still poised in the air. Then you notice it. Somehow, during the commotion, you arched your left foot upwards. You are now balancing solely on your toes, your right foot is in the air. If you put the right foot down first you risk pitching forward. Equally, if you put down your left heel first you could fall back. You look down at the ground, down, down, down. The fall will most likely kill you, and if not the pain will make you wish you were dead. You freeze right there in the middle, one false move and it's all over.

Being loved when you don't think you deserve it is like being on that wire. One false move and it will be taken away, the one thing you want more than anything else is the one thing that can destroy you. Everyday you are afraid, of loosing your balance, of loosing love. You let the fear have control, you torment your partner with your insecurities. With baseless accusations. With your insatiable need for reassurance. The more they try to reason with you, to affirm their feelings, the worse it gets. You get smaller and smaller, as the relationship consumes you. You can no longer see yourself outside of the pair; you just want to make them love you every second of the day, even if you drive them crazy in the process.

It took me a long time to figure out who I was on my own, including a small relapse into the land of promiscuity. I still don't like who I am, but I know that I'll still be the same person alone. I know I can be alone, I don't need someone else to survive. Depression does not care what your relationship status is on Facebook, but neither does happiness.

Snickers

Forgive me for the lack of posts recently, I have been struggling over the last two weeks and the keyboard was too daunting to face. Ironically, blogging is one of the coping strategies that help me stay on track when I'm struggling. Keep up the good work brain, god forbid you made sense for even a minute.

I'll stop the self-flagellation there lest I scare you away. If you are even there, perhaps I am just sending my thoughts out into cyber space, to drift unseen as 1s and 0s. Maybe I should throw in some flagged words so some analyst in a bunker somewhere in Idaho has to read my blog... Anthrax are a band I like; I also like to watch The Strain, which is about a scientist from the CDC caught up in an outbreak of an unknown virus which causes strange mutations. Heroin is a narcotic, according to the news it is regularly smuggled out of Mexico by drug cartels. Tijuana is a city in Mexico, I don't think they get much snow or ice there.

Okay I'm done annoying Tim from Homeland Security, sorry Tim.

North Korea.

Sorry, last one, I promise.

But seriously, a ridiculous number of those words are allegedly flagged. I mean have there been viable threats involving ice? Angry Eskimos? Hoards of ice cube wielding Yetis? *Gasp* Is Winter coming?

Back to the matter at hand, me being nuttier than a Snickers. After being kicked out of my college dorm I stayed in a hotel until I ran out of money. Then I slept on a friends couch for a while, trying to make it to the end of the semester before facing my parents. I had no hope of passing any exams so I didn't even bother opening a book. Instead I continued to self medicate with drugs and alcohol and slice my arms and thighs open whenever I could. As you can imagine my memories of that time are hazy, but there is one moment that stands out among all the chaos.

I was outside with a group of 1st year students I knew. If I'm honest, part of the reason I had initially befriended them was because most of my existing friends had come to a point where coursework was given priority over the more hedonistic aspects of college life. This approach did not fit in with my self-destructive lifestyle, so I needed new playmates. As a happy coincidence they were all interesting, smart and funny people.

So we were outside one day, sitting under a tree on campus. Everyone was laughing, joking, making plans for the weekend and I was sitting slightly back from them, enjoying the speed I had just sucked up my nostrils. As I looked at them I was struck by this overwhelming sense of loss, there was a sudden wrenching in the pit of my stomach and I had to close my eyes to hold back the tears. I realised that I was looking at something I would never have. This group in front of me represented everything that was lost to me - the future, possibilities, happiness. That was the first time I really believed that my suicide was a foregone conclusion. That it wasn't something that might happen, something to dream about when my thoughts grew to heavy. It was my destiny, the only mystery was when. It's a strange thing to accept your own death as fact, terrifying and liberating at the same time. After that day I no longer needed others to give me an excuse to misbehave, I threw myself head first into being as stupid as possible. It was a wonder I had any friends left, so many of them had to carry me, hold my hair or patch me up. Or just generally be in my obnoxious presence.

Luckily (or unluckily depending on how I'm feeling) I hit a speed bump on my way out of life. I had taken to smashing pint glasses and self harming in toilets on nights out. One night, unsatisfied with my attempts to cut my wrist, I decided to stab myself in the stomach. I won't go into the gory details, but it was pretty disgusting. At this point I was self harming nearly every day, I knew what I was doing. But every so often, you make a mistake. You press too deep, or whatever you're using was too sharp or you just got a bit too enthusiastic. Whatever the cause, there's a split second where you realise you've messed up and time actually stops. Everything freezes. And then it happens, before you can even blink its like the elevator doors opening in The Shining. If anyone reading this has ever self harmed, you'll most likely know exactly what I'm talking about. Well this was one of those times, I knew immediately I had gone too far. I was drunk, in a dingy pub on a night out and there were at least two hours of drinking left. So I did what any rational person would do, i wrapped toilet roll around myself and pulled back down my top and wandered off into the night. I lasted about 5 minutes before the toilet paper failed and I was rumbled.

I eventually allowed myself to be brought to A&E the next morning, where I was stitched up and referred for a psych evaluation. My mother was called, and after she spoke to the psychiatrist she told me that if I didn't sign myself into the nearest psychiatric hospital I would be sectioned. This was a lie, but one told with good intentions (I've only come to terms with that lie in the last year, it was a serious point of contention for many years. When we arrived at the hospital I was put on the closed ward, intended for acutely ill patients, including those who are a danger to themselves or others. As I was considered a suicide risk I stayed on the ward for five nights for assessment. My first time as an inpatient was both frightening, and enlightening. Fortunately my doctor decided to release me and refer me back to the day hospital programme I had attended the previous summer. It felt like I had come full circle and was back at the beginning, or the end.

Therapy

After my suicide attempt I was released from hospital and sent home with my parents(well my mother, my father living separately of course). We went to meet with my psychiatrist in college and it was recommended I be referred to the nearest psychiatric hospital. I had no health insurance, so all of my dealings with mental health services would be through the public health system.

I was assessed by the hospital, although I have no memory of it, and I was registered as a day patient. This meant that I would attend the hospital Monday to Friday, participating in group therapy sessions. I was also linked in with a new psychiatrist in the local mental health clinic. I would remain a patient of this clinic for a number of years, but as it was a public service, the doctors would change every six months. This constant change, coupled with my intense fear of abandonment, meant I never fully trusted any of the psychiatrists I met. It also meant that despite records being kept of my visits, I had to repeat my history for each new face I saw. The years I spent under the clinic were like being stuck in a perpetual time loop, always being dragged back to the past.

The Day Hospital was terrifying at first; I was incredibly self-conscious and shy, which left me feeling awkward and uncomfortable at all times. I had also never spent time with other people who suffered with mental health issues. As there was only one day programme all of the patients in the group struggled with different difficulties, and were at different stages of their recovery. I freely admit that I was slightly apprehensive on my first day, fearing that the bi-polar patients and the young man with schizophrenia might erupt at any point. I quickly realised that my per-conceived notions of psychiatric illnesses were entirely incorrect, and that the people in my group were no different than anyone else. In fact, in some ways, they were better because they understood what it was to have your own mind turn against you. There was also a sense of camaraderie - we were all there because we were suffering, and we were all there trying to get help. That is not to say we all believed the programme would work, I certainly didn't, but we were willing to try.

I spent six weeks in the day hospital; talking, painting, writing, sculpting, talking some more. I did not come out 'better'. There is no better with mental illnesses and disorders, and even if I could have been fixed, a few weeks of splashing paint across a page wasn't going to do it. But my time there gave me an anchor while my medications were being tweaked, and a safe place to go as my suicidal urges slowly receded.

Throughout this time my relationship with my father had been strained; he did not believe there was anything wrong with me that hard work or a walk couldn't fix, and he was vehemently opposed to me taking medication. When I was discharged, my parents assumed I had put all of my nonsense behind me and I was expected to get my life firmly back on track. I re-took and passed my first year exams, allowing me to begin the second year of my degree that September. My dad found me a job working in a friends pharmacy, as I had left my data entry job in a bank after my suicide attempt. College, job - as far as everyone was concerned I was back to being a normal, sane person.

But the thing my parents forgot, or rather didn't know, was that I had not been 'normal' for a long time. They believed my suicide attempt was a result of stress, that I had become overwhelmed in college and this had caused my depression. I know the college psychiatrist told them my diagnosis, but it was forgotten the moment it was heard. For my part, I did nothing to alert them to my continuing problems. Primarily because I wanted to avoid any more confrontations with them, but also because I hadn't stopped self harming and I wasn't willing to give it up. I was still struggling with intense and frequent mood swings, anxiety and depression. The medication and therapy had done nothing to change the thoughts and emotions that thundered inside my skull, so self harming was the only effective tool in my arsenal. So I kept quiet, plastered a smile on my face, and waited. Waited for that black wave to pull me under again; death was coming, I just had to wait.

Before I started my second year of college, my mother, step-father and sister moved to South Africa. They certainly(and understandably) weren't going to give the crazy 18 year old free reign in their house, so my dad paid for me to move into on-campus accommodation. If you asked me to list the most significant moments in my life, their departure would definitely be included. On a rational level, since my step-father had retired they wanted a change of scenery, an adventure somewhere warm. I was starting my second year of college so going with them was impossible, and I had no interest in living in South Africa. Oh if only rational thought reigned supreme in my mind. To me, emotional mind running rampant of course, this was yet another rejection. My father had left me as a child, my step-father had openly rejected me and now my mother was abandoning me. To me, this was her way of telling me she didn't want me. This led to my next conclusion; I was living on campus because my dad didn't want me in his house. I had always known I was unwanted and unloved and now I had proof.

My first night in my new dorm I cried my eyes out. I cried from loneliness. I cried from fear. I cried because I couldn't stand my own company, but I was all I had.

And then second year started, and it all went downhill from there. More downhill. I actually dug a hole at the bottom of the hill and just kept digging.

Killing the Thing on the Outside

In 2003, when I was 18 years old, I attempted suicide for the second time. I was home alone, with bandaged wrists from my first attempt the previous night. When I woke that day the numbness that had set in the night before remained, I felt no emotions and my mind was blissfully silent.

I ate breakfast, showered, dressed and had every intention of going about my day as if nothing had happened. But as time moved forward, as it tends to do, the silence began to recede. Sorrow came calling first, I cried because I had come so close to dying and then I cried because I was still alive. Guilt was the next arrival - if I had succeeded my mother would have had to discovered the body of her eldest child; my sister would have been heartbroken; my parents might have blamed themselves as they buried me. I was ashamed of how selfish and uncaring I was. Regret filled me.

Sorrow, guilt, and shame - I felt these things every day, and as they washed over me it was as though a switch was flicked in my brain. I suddenly remembered who I was, what I was. I was a terrible daughter, I had disappointed my parents time and time again with my inadequacies, and I was once again letting them down with the mess I had made of college. I knew I had no hope of passing my course, I was too stupid, too incompetent. My sister didn't need me, I was a black mark in her otherwise perfect existence. I was not a daughter and sister that would be missed, I was an embarrassment. I brought them nothing but misery, and they would be better of without me. They would be happier without me, removing myself from their lives was the best gift I could give them.

I was broken inside, that was clear to me now. Fundamentally flawed, without talent, without intellect and with nothing to offer the world. My outside was as hideous as my inside, I looked in the mirror and saw the ugly truth in front of me. I looked and looked, my revulsion growing with each passing second. What an eyesore I was, what a waste of flesh and bone. I was a failure; defective; repugnant. A lifetime of mistakes played in my head, the fiasco of the night before just another scene to tack on at the end. I remembered how lonely I was, always feeling like an outsider looking in. An unwanted intruder in other peoples lives.

Then the pain returned. It felt like my chest had been ripped open from the inside, and all the light in my world was sucked into the darkness. The hole pulled and pulled, swallowing all of me, leaving nothing behind but despair and misery. This pain had been a part of my life since I was a child, but in recent months it was my constant companion. It never stopped, not even in sleep could I escape it, dreams had been replaced with nightmares. As the day went on I sank lower into the abyss, unable to escape the thoughts that tormented me or the agony of being me.

I had tried counseling, I had taken the pills, I had tried. I couldn't bear the thought of living one more day with such ceaseless suffering. So the decision was made, killing myself was the only option.

As soon as I made the decision a sense of calm washed over me and I knew I was making the right choice. Everyone, including me, would be so much better off after I was gone. I felt almost giddy with relief; dying didn't scare me, living did. I poured myself a beer, gathered up my months supply of medications and any paracetamol I could find, and sat in front of the television. I wanted to watch something good, maybe even a comedy so I could leave with a smile on my face. I took the first handful of pills and started flicking between the channels. Much to my dismay there was nothing on but news and soaps, so I chose the latter and swallowed some more tablets. I topped up my beer and another handful went down. Then another, and another. As I waited for the inevitable I grew restless. Dying was taking longer than I thought it would and I couldn't bear anymore dreadful soap operas. It suddenly struck me that talking to someone would be the best way to kill some time. I checked the computer and nobody was online. My head was starting to feel heavy now, and balancing became something of an issue. I tumbled to the floor and laughed, was this what insanity looked like? Laughing as you slowly died?

I felt drunk, the xanax probably, and my restlessness turned into a sort of mania. This was it, I was finally going to destroy the body that shackled me to my pain. I wouldn't have to hurt anymore, it wouldn't matter that nobody loved me or wanted me. It would be silent in my head forever. Wait, I hadn't written a letter and my hands weren't working enough to write one now. I had to talk to someone, someone who couldn't foil my plan but could perhaps get a message to my parents. Yes, I needed the phone.

Dialing the number for The Samaritans was challenging, as my vision swam in and out of focus. From this point on my memories are almost completely gone. I remember I spoke to a woman, and told her cheerfully how I had taken all the pills and I would be dead soon. She tried to engage me in conversation but my ears were full of cotton wool and I couldn't remember why I was on the phone. She very gently asked me to do her a favour and please hang up and dial 999. I was on the floor at this point, my body limp and my head heavy. I didn't want to upset her, she had been so patient when I explained how much I hated soaps. I ended the call and with great difficulty rang 999.

"Ambulance, Police or Fire?" (Or something to that effect)
"Eh, I took some pills and the woman said to ring"

She asked for my address, I started to drift off and she shouted down the phone. Why do I have to open the front door? Stop shouting. I rolled down the stairs and managed to pull the door open. Oh good, now she can stop shouting...then everything went black.

I woke up the following day in hospital, my worried and understandably angry parents on either side of me. This time I couldn't lie my way out of the hospital. Instead I had guaranteed my place in a different kind of hospital.

I want to tell you I felt fortunate to be alive that morning. I wish I could tell you I never attempted suicide again. I wish I could tell you that my life got a little bit better everyday after that, and that now I am a paragon of mental health. But obviously I am still here, so my while there would be more pain in my life, my story hasn't ended.

Borderline

By the time I had my first appointment with the college psychiatrist, my mental health had declined to the point that every area of my life was affected. I was failing all of my subjects in college, I no longer attended lectures and struggled to focus on even the simplest aspects of my coursework. Sitting down and reading a text book was impossible - after about five minutes my mind would drift away and I couldn't even remember the paragraph I had managed to read. At home I had completely isolated myself, spending most of my time alone in my room, a stranger in my own family. I was self harming almost daily, having graduated to scalpels and burning myself. Whenever possible I would drink myself stupid to quiet the thoughts that slammed angrily inside my head, and dull the constant ache in my chest.

I had no expectations as I sat in the waiting room that day, my last encounter with the counselor had left me convinced I was a lost cause. I remember very little of what happened that day, I know I answered a seemingly inexhaustible supply of questions, posed by a smiling man with a calm voice, and colourful socks. Don't ask me why the socks stood out to me, I assume it's because they were the focal point of my permanently downcast gaze. I remember leaving with nothing but a time for the next appointment, but it's more likely that I was also started on medication that day. An antidepressant(Effexor), a mood stabiliser(Lamictal) and Xanax for my anxiety. I returned to see the psychiatrist several times and my dosages were slowly increased, as my symptoms showed no signs of abating. At one of these appointments I was told I have Borderline Personality Disorder. Like most people, I knew nothing about personality disorders, although the words immediately brought to mind the film Girl, Interrupted. My behaviours(promiscuity, impulsivity, mood instability, self harm to name a few) were all explained by this diagnosis, but I was cautioned to do no research into it, as apparently this can lead to patients developing more negative aspects of the disorder. Amazingly, for once, I did as I was told.

I wish I could tell you that I felt a sense of relief, having a name for all of the pain and torment. That finally having someone listen to me, and try and help me gave me a sense of hope. But it didn't, in fact it had the opposite effect. I kept waiting, and waiting for these magical pills to work. But they didn't. Up and up the dosage went, and down and down I went.

I was home alone the first time. Sitting on the bathroom floor, I pressed the blade as hard as I could to my right wrist and dragged it across. There was a split second, a pause in the fabric of time, and then there was blood everywhere. I remember worrying about the mess, that my mother would be cross if I stained the floor, so I crawled into the shower. I took a deep breathe, and took the scalpel with my right hand. But my fingers couldn't grip the handle properly, and my hand was weak. I was frantic, desperately trying to stab at my left wrist and failing to cut deep enough. The scalpel slipped from my bloody hand and I started to cry. I hadn't cried until then, until the moment I knew I wasn't going to die. I had done my research, it was unlikely one slit wrist would bleed enough to kill me, and I was physically unable to tear open the other one. When you try to kill yourself, most of the time you are very calm. It's as if making the decision to end your suffering finally quiets the noise in your head. It is usually methodical, and sometimes accompanied by a sense of relief. It isn't always that way, but it was for me that night. SO when I realised my plan wasn't going to work, I crumbled. I lay curled on the shower floor, sobbing, bleeding, and feeling more broken than ever.

Then the strangest thing happened, like a switch had been flicked, everything stopped. I felt nothing, I was still, my mind was silent. I know now this is called disassociation, and over the years it has become my favourite party trick. Calm now, I wrapped a towel around my right wrist and stepped out of the shower. I took off my bloodied clothes and walked to my wardrobe and dressed. I checked my purse, and then called a taxi. I asked the driver to take me to the nearest A&E, as I had cut my wrist. He politely asked me not to bleed on his seats. I laughed.

In the hospital they saw me quickly. Yes, I had tried to kill myself, but my hand wouldn't work so I couldn't finish the job. Oh I nicked a tendon?

I laughed some more.

Yes, I am on medication. Yes I have a psychiatrist. Of course I will ring him tomorrow. No, I have absolutely no plans to hurt myself again.

Stitches in both wrists. The nurse, scolding, shaking her head at the patchwork of cuts up and down my arms. I watched it all from a distance, nodding occasionally. I'm too pretty to be doing this to myself? I laughed some more. Then, suitably chastised and bandaged I was free to go. I walked home. When I got there I immediately cleaned the bathroom, removing any trace of my failure from sight. Clothes and towels were washed. Then I climbed into bed and that was that. My first suicide attempt was done, and nobody would have to find out. Everything was fine.

Until tomorrow turned into today.

I was home alone the second time.