Category: Borderline Personality Disorder

The New Business Model in Psychiatry

Published on by Nour LoutfyLeave a comment

I checked myself yet again at the hospital. It became my full time job really.

Shame on me, I ain’t strong enough to survive outside more than a few weeks. But is it really my fault?

Not more than 24 hours later, yes you know it, I checked myself out. I wasn’t scared of the environment this time. I liked the room. I even met a couple of people with whom I could have a decent conversation – shout out to K, L, N and N!

My problem was the medical body. My sessions with them were more of open ended questions like in qualitative research. I felt time had no essence to them. Like progress cannot be measured daily.

When I went to London, and I am not being payed to say this – if you only knew how expensive it actually is to get treated there out of pocket – every single word I said was taken seriously. Every little side effect was looked at. I was seen as a person; a real person and not a spoiled brat complaining for no reason.

Secondly, the doctors would not dwell endlessly on what to do. They took calculated risks. Because if they agreed to the status quo then nothing would happen.

I was always reassured and never ever did anyone tell me this drug or this method works for 20% of the patients. I was given hope – in abundance and also had the opportunity to chat with other patients who are now truly healed.

While I was completely fitting the box of patients in the clinic, my individual voice and needs were immediately heard.

That is why I felt I was wasting time at the hospital and that is why I left 24 hours later instead of staying for a whole 10 days.

My business teachers at university always said a good product or service starts by answering a customer pain.

Very well, mental illness is filled with customer pain; be it the patient herself or her family members.

I have been treated and admitted to hospitals both in Paris and Cairo. Although the settings could be strikingly different; there are major similarities.

Patients have little control over the course of their treatment; unless they happen to well read – and still that could be interpreted as a personality disorder.

Here, business people, here is a business model for you to follow. Instead of keeping the one patient coming back for 10 years, you can have thousands of them and most likely very happy ones too. Am no mathematician but get your excel sheets out and do the works. It doesn’t need a genius to tell you where the money is; and coincidentally health too…

TBC

Capitalism and bipolar disorder

Published on by Nour LoutfyLeave a comment

My illness relates to many many factors. It is my upbringing and my biology. It is society, it might even be fate.

My illness maybe relates the most to a lifestyle, no; to a mode of being that I am not the only one to have created but surely had to abide to. My illness is so common you would be surprised. My illness is “in” these days. My illness is a mutation, a mistake if you would like. My illness is a blessing as much as it is a curse.

I get to the downs of the deep blue and sometimes I stay afloat. Sometimes I even catch a boat, a sailboat- nothing too fast. I wonder and I ponder about my existence and yours. I shed a few tears and even pop a few pills.

I always end up where I started with mixed feelings about everything. Nothing is my favorite as how should I know? My illness changes my mind as I grow.

Something is constant amidst this storm. I know there is a malfunction, that much is true. Why does it relate to inequality go ahead and ask me. All is a competition, life has become a race. We run around all day seeking a bigger dream. I don’t get there and you don’t either, but why does she? Born in here, studied in there, oh that is her family? Where is my choice in all of this? Where is this leading me? Achieve and fail and fail to achieve. I ask myself why I stopped dreaming. Those images were not mine but yours, so why keep them in the first place? Illusion, delusion, materialistic being. This is not whom I should be. Why wake up and swirl like a mouse? That’s when I decided not to leave the house. I felt immense fear from life; how on earth can I win this race? Exclusion, demotion, gender roles or nationality?

TBC

Raw on hypomania

Published on by Nour LoutfyLeave a comment

3:15 Am, four Xanax later, one hour on SoundCloud, about 15 cigarettes, two herbal teas, some half pack of almond thins, an Instagram and a blog post published, and as sleepless as a toddler who just won’t nap.

I wake up nightly between 2 and 4 AM. It is a killer, but it is the period I feel the most creative- unstable but creative.

I can almost smell coffee, its rich and dark brewing aroma inviting me to take a cup. Just a sip. I can also see this gin tonic fresh and calling my name. I don’t want to eat, I want to binge drink! Isn’t that a word ? It is now.

I cannot have coffee or gin as a matter of fact. Doctor’s orders. No stimulation. None. No sports. Mot even hot yogaZ Not that I was your athlete or alcoholic. But still, breaking a sweat, sipping a nice drink…

If I had hold of a car now, if I knew how to drive on the “wrong side of the road” here in London, I would have gone for a cruise. The type of ride you have when you are what 19? Windows rolled down, music loud, singing along, no care in this world.

But am in my pjs, sneaking out in the cold to smoke yo my cigarette with my yogi tea and slippers with my toes freezing like a good girl.

No make up tonight. No tight dress and high heels; first no freakin tight dress would fit now and no heels in the suitcase.

But what is a woman without day dreaming? I have lipstick. I can do lipstick at 3 am or full make up if I want to.

But now the ride is coming to an end. SoundCloud is asking me “how deep is your love?” And am like you have no idea how deep is my love. My eyes are opened and I have devotion and it is bigger than the ocean.

I am making sense, don’t give me this look. Am in Ibiza but in primrose hill and that is totally fine.

Am managing my hypomania which was just suicidal ideation about 5 hours ago. Screw that, I want to be by the beach. Close my eyes, walk on the sand. I am in control of my emotions or not. I can run or swear. Heart rate is my affair. I stimulate and get stimulated as much as I need or wish or both.

Honestly. This is my first hypomanic post. Raw, unedited by my subconscious who wants me to look wise and smart. I just want to party… was it all a dream ? Back to my herbal tea

Please no excuses

Live whitest you can

TBC

I am committed

Published on by Nour LoutfyLeave a comment

I am committed to coming back to this very hospital

I am committed to receive every form of therapy there is under the sun

I am committed to doing whatever it takes to raise our children, see them graduate and organize their weddings

I am committed to loving and honoring my immediate and extended family in every possible way

Meanwhile I am finding my happy middle

It is a mirage

But I need to keep on looking

I will check out tonight if it is the last thing I do

I will come daily as an outpatient

I am committed to heal

I am committed to survive

I just checked myself in a few hours ago and now I want to run through the iron gates and never come back.

I cannot deal with my thinking, my needs, my wants, my moods.

Is this a magic spell?

Get me in here

Get me out of here

My patience is nonexistent and my insight is blurred with my tears.

End this torment for I am at the end of my rope

This song is on a loop and it won’t stop

TBC

Worry of hope – rapid cycling

Published on by Nour Loutfy1 Comment

It’s 5 am and I cannot sleep.

I am angry of myself. I am angry of the world. I am angry of hope.

I am supposed to try a new treatment soon. My mood changes more than I can handle. I am up and down at the same time.

I put on my trainers and went down for a walk.

Am writing and waking while listening to music. That is how restless I am.

I am worried it will fail

I am worried I will fail

I am worried I will fail them

I am worried they will fail me

End up my post with the usual

God grant me the serenity to accept the things I cannot change

The courage to change the things I can

And the wisdom to know the difference

TBC

You must know

Published on by Nour LoutfyLeave a comment

Know that I love you since before I was born

Know that I loved you since before you were born

Know that you are my every reason for being

Know that I want to leave to set you free

I try and I fail and I try again and I fail and fall harder

Maybe this time it will work

In the world of rapid cycling

Published on by Nour LoutfyLeave a comment

Hello everyone. Bla bla bla yes I haven’t written for a while, miss you, etc.

You know it is not me who is inconsiderate or rude: am rapid cycling.

Say what? Say one day am high as a kite (a small kite since am bipolar 2), and the next am digging a tunnel to the the after life (does that even make any sense?)

You get the picture. Am a yo-yo, I am a roller coaster, a bullet train with bad breaks.

I enjoy my ups and do accomplish a lot; especially if you count shopping as an accomplishment. I spend hours without eating (big high five since I tend to feed like a newborn every 2 hours). I even live on 5 hours of sleep and I am Eeyore on any other day.

Woke up at 6 am today (weekend here on my side of the world) and hoped into my trainers and on to the kettle and to my smokes.

Am sociable, am pretty, am smart and talkative. I love it.

I wrote this down to me Nour. Yes to me, for in a few hours I will feel like dirt is better than me. I will feel empty and useless and I will become a burden. I will get back to staring at the ceiling and doing nothing but dealing with suicidal ideation.

Today however I will kiss my kids, a lot and lots more. I will go for a long walk like the book says. I will have lunch with my beautiful loving family and I will dress to impress. I will put on my make up and my new earrings. I will take a selfie or two and hashtag them to mentalhealthawareness.

Meanwhile my rapid cycling friend; I freakin feel you. You are my hero.

Remember, for every down there is an up coming and heck yes we shall ride the wave and rise to the moon.

Bless

TBC

Choosing to live with the side effects of psychotropics – a life changing decision…

Published on by Nour LoutfyLeave a comment

I saw my psychiatrist yesterday.

I told her about my “attacks” and she explained.

She told me that hormonal changes in female bipolar patients tend to send them over the moon sometimes. So what I am going through is not surprising. It is not a hormonal problem per se, it is just a confirmation that I have a mood disorder.

I asked if there is any biomarker that would tell us if I need a hormonal treatment to fix my mood. She said that there is currently no information on this. Surprise? Not really. So the only marker hormones wise is that of the thyroid gland functions. My numbers are not perfect, but not alarmingly different to cause such an imbalance.

My session was important despite the “negative” results. I now know that I need to make a big decision.

My doctor asked me about whether stopping lithium was due to hypomania and I said it was not. I would do this over and over again. The changes, the personality changes that most psychotropics cause me are just unbearable- to me. Again, this is such a personal matter that it would be straight stupid to advise anyone to quit or not. I am not preaching anything. I am just sharing my own journey, which might or might not be similar to yours. What is sure though, you might have gone through similarly difficult choices to make.

We agreed that my life as it is now is not fulfilling. The unpredictability of my attacks renders my illness a disability to me and to those around me. We are unable to plan anything. I struggle to be an adult, an independent person who requires little or no maintenance. I struggle to be there for my children as a full time mother. Career? What is that sir! Sometimes having a shower is already a challenge to me.

Having said that, my worst fear is hurting those around me. Till when can they deal with my unpredictability.

Till when will my husband take days off work, or leave the house with a feeling of apprehension not knowing if he will find me home when he gets back.

Till when will I have my father leave everything and stick around to be here just in case I cannot deal with the children. Till when will he hop on and off plans to come to an emergency situation beyond his or my comprehension? Till when?

So fact one; we know this cannot go on.

Fact two; there is no clear solution.

My dear doctor whom I respect so much suggested that I add a new psychotropic to my daily dose of Prozac.

“Psychotropic drugs are medications that affect your central nervous system, changing how your brain processes information, such as altering your mood, thoughts, perceptions, emotions, and behaviors. Most psychotropic drugs are prescribed by your therapist or health care provider to treat a diagnosed mental illness, such as bipolar disorder or borderline personality disorder.”

https://www.verywellmind.com/psychotropic-drugs-425321

You see I don’t have a conscientious objection against drugs. No, I don’t. The thing is with most drugs I feel alienated, weird… I twitch, I get nightmares, I get lethargy, restlessness, anxiety, and sometimes I even have suicidal thoughts that unfortunately led me to the emergency room more than once.

She said the new drug- Abilify– could help regulate my mood. The idea is to take it at 5mg – a super low dose – to keep my curves from skyrocketing or dropping at the speed of light. Sounds good yes. I would have to wait a few months to monitor the effect of Abilify on my mood and on my menstrual cycle.

Will it work? We have a fifty percent chance it does. Ok, side effects? For starters, it is prescribed to children. How bad could it be?

Then Surprise surprise, they said when they put it in the market that it does not make you gain weight. Oups! Mistake, she said it does in many patients and my readings confirmed a nice 10 to 20 kilograms of extra weight per year. Maybe at different dosages, but still. I won’t be able to tie my own shoelaces by 2020.

Ok. What else? Oh it varies greatly she said from one person to another. Reading suggests that the worst is in the beginning; like vomiting and the like. That does not scare me. What really scared me is that patients on this drug would complain of very low energy and of restlessness or need to move.

According to the official site of the drug,

“ABILIFY may cause movements that you cannot control in your face, tongue, or other body parts. Tardive dyskinesia may not go away, even if you stop receiving ABILIFY. Tardive dyskinesia may also start after you stop receiving ABILIFY.”

https://www.abilify.com/important-safety-information.aspx

They might get also compulsive behaviors such as gambling and binge eating, cholesterol and anxiety.

How are you supposed to fight depression with all this extra weight and without any energy, with twitches and compulsive behavior? Don’t tell me stop searching the Internet. I did differ from a wide spectrum of side effects before. They are as real as it gets.

Her idea is that my Prozac would have a counter the side effects of Abilify and things would balance out. Perhaps…

So my dilemma is simply the following:

Should I risk living with these unpredictable cycles and watch myself and my family losing our minds slowly; or should I take the drugs and lose myself little by little and become a deaf note floating around in a soundless world?

Can you relate? Did you go through the same? Can you throw me a bone here? What did you do? What would you do?

God, grant me the serenity to accept the things I cannot change,
Courage to change the things I can,
And wisdom to know the difference.

TBC

If I were

Published on by Nour LoutfyLeave a comment

If I were at the hospital

I would wear my pyjamas all day

I would say good morning to everyone

I would wake up on time

I would have breakfast at the communal table

I would go for a smoke when the nurses say so

I would wear a nicotine patch To get me through the day, and I would be allergic to it

I would use the communal shower and dry up with a bed sheet; I would find hair everywhere and stay with my slippers on

I would wait for the doctor to pass by and say the daily bla-bla-bla;

I would play Sudoku- pen and paper sir not online

I would stare at my family’s portrait hung on the window and imagine them touching my face

I would move my chair around to be in the sun, seeking emotions and failing to find none

I would be disconnected; off the grid and not feel guilty about it

I would pretend it is doing me good to be here

I would take my blood pressure and temperature every day

I would talk to others about side effects of this or that

I would fancy getting better

I would know it is good for me, it has to be; it better be

I would feel guilty about the kids, my husband, my father; my kids, my husband, my husband, my husband, my father, my father, my father, my father….but my kids…

I would wait for 2pm when visits start, no no tears this time

I would wait for 7pm when I can call the kids and ask them to sing me a song, sometimes they would

I would give them imaginary baths and diners

I would blow imaginary kisses and I would make belief that I am tucking them to bed

I would kiss my husband good night and say a silent prayer, god let tomorrow be normal – one more day

I would beg for the drugs to black me out at 8pm

Dinner would be sprouts and more sprouts. Some borrowed olive oil here and some salt

The other day I took the kids bowling and felt so self accomplished just as if I landed on the freakin moon

I am sitting by the louvre sipping my Bloody Mary with tears

People are standing up here and there trying to get a perfect picture

They bend and jump into strange angles to look like the pyramid is on the palm of their hand

It is all make belief, looking for the perfect moment

A tour guide has an umbrella up for everyone to follow her

Where else would they go I wonder? Isn’t this the perfect moment? To follow someone without thinking? Tick this box and that one. Been there, done that…

We talk and talk and talk and talk

We shut up and up and up and up

We should know better

I am writing compulsively, but you don’t have to read me

It is building up

I know myself, I wish I didn’t

Solve it; for you god brought me here in the first place

No shame; maybe some

No regrets; just a few

Oblivion where are you?

TBC

Solace, where are you?

Published on by Nour LoutfyLeave a comment

I would like to shed my skin like a snake…

I would like to change colors like a chameleon…

I know that personal growth is not always linear.

I know also that sometimes you keep on suffering until you learn the lesson.

Things are more bearable during the day. Yet, when the sun sets, and as the sky becomes darker, there is little left to be done. The few chores of the day end one by one.

I sneak back to my corner in bed. I hold my phone and do nonsense. Minute after minute, tic toc. It is past midnight already. I count the hours I have left in bed, and dread facing the next morning. I will myself to sleep but know to well that this is not how it works.

Someone else got into the control center in my head and took over. I am equally lost between trying to fight and surrendering. They are the same.

I’d do anything if I could. Like walking on shifting sand I lie on this side then on that side seeking comfort.

I finally fall asleep but my dreams are no solace. Of course they are vivid. I stopped trying to know what is true and what is not. They are as real as it gets, and also as fake as it gets.

I usually fixate on things in my dreams. Small details, they keep on coming back. I wake up without any memory of what happened. Just a feeling of weirdness and abnormality. Too much brain activity or too little. All the same.

I find small feet cuddling next to mine. They are seeking comfort and safety in me. In me…

I wake up to the sound of the alarm and hit snooze. I wish I could escape from the responsibility of being me.

I wish I could let go.

I worry about my family and how they will react – again. Pity, love, empathy, boredom, anger, what again will they feel.

I can see my temporary paralysis turning beautifully into a handicap. Will I need to be taken care of again? Till when I wonder… Will I ever be an adult?

I don’t know what to do with every single second of my day. I listen to this song then forward to another. I watch this show and then another. I go out for a smoke then decide it is too cold. I want cookies and cheese at the same time. What the hell is going on.

You know I wish I had a timeshare at a mental clinic. How cool would that be? Hello yes, this is client 44087. I am calling for room 13. Yes, is it time already. Is it empty today? Sure, like last time yes. I would like to start with the locked up package first. And I insist, don’t let me out even if I beg you too. That’s it then. See you later. Oh yes, I know the drill. No sharp objects of belts. Thank you.

Perfect customer service.

A few weeks after, my skin would have shed. Yes I am a reptile after all. Why? Oh am also a chameleon and I change colors all the time. Only difference is this is not for adaptation like reptiles. It is a malfunction, a mutation if you prefer.

At the end of the day, survival is for the fittest…

TBC

The tunnel at the end of the light

Published on by Nour LoutfyLeave a comment

I wake up and find out that the life I thought I had is slipping through my fingers.

I look at myself in the mirror and I don’t see me. My son tells me what is wrong with your eyes? He is three.

Where is my silent mantra? Where is my magical oxygen?

Like a broken record, or a bad movie that always has a sequel…

I am just a

Racing heartbeat

Cold limb

Thought with echo

Foggy brain

Shallow breath

Flushed face

Spent energy

Headache

Backache

Fear

Silent scream…

I ask myself. Are you coming back? Are you already here?

I can’t be. You left me, remember? You almost promised not to show up again…

Why is it always payback time? Didn’t you take enough through out the years?

I have nothing more to give or to give up. I surrendered everything. You took it all away.

I am hesitant again…

I am dizzy again…

I am in bed again…

One of us has to leave and it cannot be me. I told you this before. I cannot go, it has to be you.

These cycles are endless. They tell you there is light at the end of the tunnel. Sure thing. Can’t argue with that. But they fail to mention that there is another bloody tunnel right after the light.

TBC