I have a new outlook

Subtle changes in behaviour have improved both Alex Williams’ mental health and her view of life.

Sometimes I ask my community psychiatric nurse: “Is this as good as it gets?” I sometimes feel as though my recovery from complex mental health problems has slowed down or stopped completely. My fear is my life will always remain the same. But recently, I have shared with her changes in my thoughts that indicate how things are improving.

Since I was diagnosed with an eating disorder at 17, I have looked to other sufferers as role models. At times I have envied women who were emaciated through starvation. Instead of thinking how ill they looked I would consider they were in control. When I was in hospital with anorexia, I would resent new admissions because these patients would be at their lowest weights. With self-injury I had compared myself with others and had urges to “outdo” the harm other patients could create. 

What underlies this is a wish to receive the same amount of concern from health and social care professionals commanded by those whose actions have more serious consequences. Last week, my CPN pointed out I no longer envy others who were unwell after I told her about a friend who had complications from an eating disorder. I can now see the physical damage done by self-harm in its many forms as long-lasting and an additional burden.

When I came out of anorexia I started to have suicidal thoughts. For weeks at a time I was fixated by suicide. I would walk to multi-storey car parks and plan the final jump. I would go into chemists and look at the painkillers. All the time when I wasn’t suicidal, I kept thinking it would be easier if I wasn’t alive and would wish I didn’t wake up the next day. Now I value being alive. Good health – being nourished, a healthy weight and not anaemic – has helped change my views.

My relationship with self-injury has shifted. It no longer defines me. For a long time it was a way of life. I did not always cut because I was in emotional pain. I cut since I knew I would be distressed if I did not harm myself that day. The change means that I only cut, to a much lesser degree than before, if I feel I have no other option.

In the past when I was chaotic or feeling unsafe, I wanted to be an in-patient. My last admission to a psychiatric ward was in December 2004. During my stay I was given leave on the condition I didn’t go home and cut myself. I still self-harmed when I was on leave and made an early return to the ward. As much as I hated every moment of my time there it was safe and predictable and I didn’t have to clean, cook or look after myself. I could just stay in my bed waiting for time to pass and for the next ward round. Today I do not anticipate needing a hospital bed again. I have  outgrown this level of care.

Changes in thought patterns are subtle and often unnoticeable. They follow adopting different behaviour. Even if you have lapses with the behaviour the new outlook is unharmed.

Alex Williams is a mental health service user and volunteer

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