I am amazing. Mental illness recovery.

When you watch something like this and think how incredible and kick-ass a person is for overcoming so much difficulty on such a huge metaphorical stage… I’ve come to realise in the last few days that I am also incredible and kick-ass for the trauma that I have overcome and the mental illnesses that I live with.

I’m being admitted to Tara (psych hospital) for 6-9 weeks on Tuesday and I am so ready to make significant shifts in my living and thriving with mental illness. I am a hero. I am a warrior. I am amazing. #mentalillness #BPD #PTSD #complexPTSD #bipolarII #mentalillnessrecovery

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Recovering, not recovered

I love the Facebook memories because they allow me to see where I’ve come from. Like a journal. Today this memory reminds me to never use the word “recovered” in relation to a chronic mental illness. I’ve been hospitalised twice since this update three years ago.

Recovery is an ongoing process. And a fucking difficult one; like trying to spear a tomato seed with a fork. And while this reminder is sobering and makes me realise that working on myself sometimes leads me in circles to places that look like the beginning again, I have to remind myself that those circles are an upward-moving spiral and that each rock bottom never reaches the depths of the first one; because I keep learning about myself and these illnesses (because BPD is always accompanied by a mood disorder and/or other mental health disorders).

And it’s important to call it an illness. I realised recently that I think of it as something fundamentally wrong with me: something I can control, and if I can’t control it I’m being lazy. But seeing it as an illness reminds me that some things are out of my control, which makes it easier to pinpoint that which I can work on and change.

Anyway, thoughts while feeling simultaneously defeated and resolute.

Don’t wait for rock bottom to get help

So, to my surprise, I’m actually doing ok since leaving the psych hospital on Sunday. I’m mainly focusing on keeping the momentum of the routine there: waking up at a decent hour, three meals a day, showering, reaching out for real/virtual cuddles.

I want to share this with you: I was not suicidal. The reason for my hospitalisation was that I was incapable of self-care and have been stuck for two years. I felt that I wasn’t “sick enough” to be hospitalised. My therapist blew my mind when he said that hospitalisation can also be good as a preventative move; to avoid getting more sick. The same with the impending admission to Tara (another psych hospital): just because I’m feeling relatively ok now does not mean I don’t deserve a safe space away from the severe stresses to be able to immerse myself in a space where I can work on myself.

So, I want you to know: you do not need to wait until you’re at complete rock bottom to deserve care and help. Taking the step to discuss admission with your healthcare team is an embracing of the truth that you deserve care before you drown.

Mental illness & health insurance fails

So Discovery (health insurance) has done its money over care thing again and instead of paying for 21 days only paid for 11 days in hospital. Which also means they won’t pay for outpatient psychiatry or therapy anymore…

Home since yesterday. Going for assessment at Tara on the 13th of May where I won’t have to pay as it’s a part government hospital. But I’m on a new treatment plan for my newly diagnosed Bipolar II (and not severe depression as I’m treatment resistant to those meds), Borderline Personality Disorder, Complex PTSD and Social Anxiety Disorder. Also have an amazing new psychiatrist and will be seeing a social worker. Will also be applying for 6 months of disability while I get editing and proofreading work in that will pay my bills.

And I shaved.

Sometimes self-care is community care

I’m being admitted to a psych hospital today for the next 21 days.

Sometimes self-care means asking for help. Sometimes self-care is community care. The belief that we’re “not trying hard enough” or are “too lazy” or have to do this alone is a harmful coping mechanism which denies the fact that much of mental illness is out of our control. Getting the correct diagnosis, the right medication and the right treatment plan for therapy gives us power over the parts we can control.

Getting real about recovery

In the spirit of “secrets make you sick”, I’m getting real with myself by getting real with you, because it’s easy to avoid stuff when I’m in my own head: For the last 6 months or more

– I have had two days of work a week and I’m really struggling financially, with my income being R5,000 short of my budget.

– I sleep 14 hours a day.

– When I’m not sleeping I’m watching series, movies or aimlessly scrolling through social media.

– I shower once a week.

– My flat is a mess and I don’t clean often enough.

– I’m not exercising or eating healthily.

– Apart from a friend once a week and my therapist every two weeks (Skype), I don’t get out of the house and have no human contact (all my own doing).

– In short, I’m wasting my life.

The frustrating thing is I’m not hectically depressed, and I know exactly what to do to get out of this slump. This leads to self-recrimination and self-flagellation, telling myself I’m lazy and that there’s something wrong with me.

I know that I’m a person who does very well with a strict routine. I flourished at school and university where guidelines were imposed. I now realise that it’s not that I’m lazy or that there’s something wrong with me. The issue is that I struggle, and have always struggled, with self-regulation. I never learnt the skill of being by myself, filling my days and life, and self-imposing routine.

These are things I need to learn. It’s that simple and that difficult. It’s a relief to realise that I’m not at war with myself, but at war with an emptiness born from skills I never learnt. It’s a relief knowing I can teach myself these skills by implementing the structure I crave.

Depo Testosterone: Nationwide shortage in South Africa

So, Pfizer, the only producer of Depo Testosterone (testosterone cypionate), the testosterone used by at least 80% of the trans, non-binary and intersex population of South Africa, has “run out” of the product. It is the most used T in South Africa because it is the cheapest.

So switching testosterone types is not an option for most of us. Switching testosterone also comes with a host of problems. The other forms of T are not comparable to Depo T in terms of chemical make up. It would be like switching from Prozac to Cipramil.

This has HUGE health implications for us. It’s a hormone, so controls a multitude of body functions. It controls moods, and with a large number of trans people struggling with depression, this has serious health implications.

Then there are the masculinising implications: we would begin to menstruate again, lose muscle, have fat redistribution occur – all things that cause us unbearable dysphoria.

Pfizer has said they will have stock end of February again. This means that we will miss 4 shots (those that tried to fill prescriptions earlier have missed up to 8 doses). 4 Shots that balance our entire bodies’ chemistry. 4 Shots that make life livable.

Testosterone is a chronic medication. The trans community is in a panic. This is completely fucking unacceptable.

Please share and tag Pfizer in Sandton. Let’s put pressure on them to remedy this national healthcare failure.

UPDATE:

Re the Depo Testosterone shortage:

So I’ve just spoken to a friend in Australia. They stopped producing Depo T early last year. He had to change testosterone types 4 times last year when the supply of Depo, Sustanon and Primoteston ceased. He is currently on Reandron.

He’s also in the medical industry and gave the perspective of the pharmaceutical company:

Bottom line is that pharma has not caught up with legal and human rights progress for trans people. They budget for the production of meds based on what Drs prescribe. This budget it drawn up 5-10 years in advance. Which means that they budgeted for HRT according to state of transgender issues 5-10 years ago and they have been caught unprepared for the suddenly increasing demand for testosterone by trans people.

Answering this demand is therefore not as simple as producing more T. They not only have budget constraints, they also place their emphasis on global crises like ARVs and insulin. Parkinson’s and Alzheimer’s are also on the rise. Also, production of more Depo T is not as easy as it sounds. They need to go through the process of testing the new batch of product and go through the red tape of ensuring that the product is up to medical standards.

So, it’s a case of supply and demand, but with processes that make supplying the demand a difficult thing.

Of course the good news, with pharma obviously being a money-making enterprise first and foremost, is that they are aware that there is a lot of money to be made off HRT and pharma giants will push to be the biggest supplier.

In the short-term, this means that we in South Africa will have to change to Nebido or Sustanon until the supply of Depo T is fast-tracked. This will, of course, be a huge finanial issue for the majority of the trans population, but we need to be aware that this kind of thing happens globally.

So, basically, pharma has to catch up with the increase in trans patients and the right to healthcare that has been granted by the World Health Organisation.