The End (Of Day Care) Is Nigh

This is a blog about depression. If you are easily offended or take offence to my very sarcastic humour, please do not read any further. Mental illness is not a joke; it is not something to point fun at and I fully understand that. BUT…when the going gets tough, sarcasm and humour is my defence and so I will be parading it around all over this blog.


If you need help, please get it. Whilst I hope this has a happy ending, I don’t know yet and given I’ve not been able to fix myself, I really don’t want others using this as a ‘How To Be Happy for Beginners v2.0’



It’s Day 95. It’s Friday. It’s the last day of day care. It’s a big day. To celebrate this milestone, a milestone that I don’t know where in this invisible recovery plan it sits, I get a taxi as I have a money off voucher. I get there with plenty of time but I am feeling a bit strange. The last day of therapy is a hard one. I have things I want to discuss but I am very conscious I don’t want to start a topic that I can’t finish in 1 day. Basically, I don’t want to be left hanging. This coincided with the administration mix up means I am not entirely sure what the purpose of today is. I feel ready to say goodbye to day care yet not ready to try to do this on my own at home either.


I walk into the room ahead of the start time resuming the standard Patient C position equidistance from the door, the therapist and the white board. Yes, for an OCD sufferer, I can apply my stupid rules to anything.


In walks Therapist J3. Woah woah woah. Hold up lady, what do you think you are doing? You are not Therapist W, you are not our Friday morning CBT therapist. What’s going on. Well, given we are sometimes reminded that therapists are fallible humans too, it turns out he’s taken a holiday. I feel put out. I mean, why did he not think to consult me on such a major decision? I jest but deep down, I kind of wish I’d know this before arriving! To add to my disgruntled state, Therapist J3 then writes ‘Weekly Review & Goal Setting’ on the white board. You little sh*t. I mean obviously, I don’t mean her directly, although maybe I do a little bit. I hate these sessions. I can do a week review at home, I don’t require a therapist to sit watching me write. I’m getting frustrated. Those long-term sufferers a.k.a. readers of the blog, will remember I walked out of a session like this once before. So I check in and tell her that this is my last day and I really wanted/ needed (delete as applicable to my mood minute by minute). The therapist isn’t going to give in to my mini protest of the week review which, I get. So, week review it is. I start writing and am relieved she’s not asked us to do it in pairs like prior therapists. Why the lack of interest in pairs work? Patient H is next to me and, no word of a lie, has told me how pleased he is that I am here about 10 times in the last 5 minutes. That’s once every 30 seconds. That’s a lot of feeling pleased.


We start at the other end of the circle of patients. Patient J3 is first and, given he’s been here as long as I have plus is due to be here another 4 weeks, he’s equally fed up with these sessions. As we work our way around the group, I realise there isn’t going to be time for me. Time management is the responsibility of the therapist, not the patients, but Therapist J is rapidly working her way up my dislike list by not realising we are running out of time. I’m getting agitated and, I am embarrassed to admit, I am turning to childish behaviour. Yes, this 31-year-old is going to bring out the 7-year-old. With 5 minutes to go before the end of the session, Therapist J3 asks if everyone is ok to run over as it’s my last session and I’ve not had the chance to speak. Out comes 7-year-old Patient C cleverly disguised in a 31-year-old body. No, it’s not ok, I can’t stay late, I have a 1:1 with my consultant, Dr. E, and I need lunch. Therapist J3 is quickly realising she’s messed up, as she tries to find a way to help, the 7-year-old brat starts attacking in full force. No, it’s fine, it’s not like I still need help. Yes, I am scared about the next ‘chapter’ and yes it would have been useful for time but no no, you carry on trying to find a solution. Then, Therapist J3 asks if I can consider the next couple of weeks as an opportunity could I start a new hobby or do a course? Urm, HELLO THERAPIST J3, if I could look at being ill as an opportunity I am not sure there would be a psychiatric hospital. I’d probably not need intense therapy. The 7-year-old barriers are up and they aren’t coming back down in the short-term future. Then, like every 7-year-old, I storm out and head to the restaurant for lunch.


Now, before we move on to lunch, I am aware, I’m being a prat and a brat. I walked into today with the wrong mind set so to be honest, it’s hardly surprising I didn’t handle it well. I’m frustrated because Therapist J3 ‘should’ have been in control. It’s her job. Also, I am the only patient in Group 1 being discharged in the next 5 days so surely, you’d make time for that patient? My stomach and head aren’t coping well with the thought of a couple of weeks with no work and no day care.


Back to lunch and it’s a delicious. It’s a quinoa burger and I ask for a very small portion of chips. I am determined to break the binge cycle. Given the 1:1, I inhale my food and don’t have time to battle the decision about skipping pudding. I head to the waiting room for my appointment and in walks Colleague. Thankfully, there are no new surprises. We chat about the fact it’s both of our last day as a day care patient. Colleague was inpatient for less time than me and the insurance hasn’t granted an extension to their day care. We talk about next week. Colleague intends to survive this by throwing themselves into the gym. It’s a huge relief for them. I’m jealous. I am obese, trying to break the binge cycle and climbing the stairs feels a big ask, let alone a gym session. I know there is a lot of evidence to support exercise helping mental health but no one considers how hard it is to get started, especially when I only want to hide in my flat.


Colleague gets called to go through and I wait in the waiting room. A new patient is in the waiting room. New patient has a lot of bandages on. Slowly over the next 10 minutes, more and more family members come to join him. I don’t mean to ear wig and I am only sharing this because it highlights a severe hole in the NHS care. It’s an emergency appointment, the bandages are clearly new. As the family members arrive, it becomes apparent they aren’t from London, in fact, they are Scottish. I grasp from their conversation that, once the gentleman had been bandaged up by A&E, they were told it would be a 6 week wait for the NHS mental health crisis team. For those who are lucky enough to not know what this is, each NHS trust has a crisis team to see people who are, unsurprisingly given the name, in crisis. By definition, there is an immediate threat to the patient. 6 years ago I needed the crisis team. I was stood on the train platform timing the trains going past to work out which was quickest. I was stopped by a platform guard who had clocked what I was doing. I went to the GP and admitted everything. The GP correctly launched the crisis team process. My wait time? 2 weeks. By which point, I returned to work and the crisis part of my health had passed. This patient had been told it was a 6 week wait. The family, by some heroic means had managed to get their family member to London and were going to self-fund the care. This might not shock you so I am going to bring the broken leg analogy in. Firstly, a broken leg isn’t life threatening but I’m going to stick with it to highlight how much of a hole we have. If you had broken your leg (seriously people, be a bit more careful), and were in A&E waiting to be seen, can you imagine if they turned around and said it was a 6 week wait for an X-ray? That’s the first part of the doctors being able to help mend your broken bone. They doctors won’t even put a cast on it until you’ve had an x-ray. The crisis team is meant to be the first assessment to help put a care plan in place. 6 weeks with a broken leg would be agony. Your life would be put on hold as you wouldn’t be able to walk on it, especially without support such as a cast or crutches. Now, imagine you want to kill yourself. You are in desperate, unbearable pain. The only way to stop the pain is to die. You don’t want to die but you can’t cope with things as they are. Suicide would stop the pain unless you can get your ‘x-ray’ a.k.a. crisis team assessment and help. Then, imagine being asked to wait for 6 weeks. The pain is excruciating, there is no way forward, that you can see at least. 6 weeks is a gigantic chasm to ask a person to survive. This family are ‘lucky’. Their relative is alive, albeit severely injured and ill, and they’ve somehow managed to raise enough money to get him to London and into a private psychiatric hospital.


I am shocked at the injustice. The NHS is a wonderful thing and it’s come to my aid on numerous occasions, but I am so cross that it’s only the privileged few that have access to the phenomenal care I’ve received. I am in no doubt that I would have gone through with my plan. I’d actively put things in place to make my death easier. If I’d not had an incredible insurance plan, I don’t know the NHS would have scooped me up to help me.


Moving on, this blog isn’t meant to be a political petition but I had to share that. Last time I saw Dr. E, I felt she told me off. I’d been told that planning my death was not part of our therapeutic contract. She was right, obviously, but it’s making me nervous to see her. A bit like seeing a teacher after being told off. I enter the room and try to verbalise what’s going on. Thankfully, she validates my stress about the administration error so at least I didn’t blow that out of ‘Normal’ proportion. We talk about plans for next week, when she can see me and changing my psychologist. We run right up to 1400 so it’s a quick jog back to the main hospital for IPT.


Therapist J is leading the session so there are no nasty surprises. I check in again stating it’s my last group. I state I acted like a child earlier and I’d like to ‘explore’ that in today’s IPT. The rest of the group check in and we start with Patient C4 and her fears about her job. Others chip in and a few others also take some time on the same theme. This isn’t my topic though, this isn’t something I am grappling with. Before we know it, there is only 15 minutes left and yet again I feel let down by the therapist. Therapist J checks in with how am I doing? Well, pretty peeved to be honest. I had no time this morning and now, with 15 minutes to go, I’ve got no time this afternoon either. There is no point in me opening up about my childish behaviour now is there. So, we enter check out. I simply state ‘I am fine’. I am not fine but I’ve got no choice.


As I stand up to leave, Patient H asks if he can have my number. I feared this would happen so I lie. I state I am in a rush and I’ll ask another patient to pass it on. I have no intention of letting him get hold of my number!


I walk to the bus stop and head home. I am in a weird mood given today feels like a complete waste of my time. Once home, I start to get the binge cravings. I really want to sit and stuff my face with my emotions. I text a couple of people for support and sit at the table with my planned two biscuits. Today should be the hardest, I’ve just got to get through today. I busy my mind with Sudoku for the next couple of hours before having supper as planned. Shortly after, I wash my face, brush my teeth and head to bed. I can’t binge whilst asleep so that’s going to be my way through this.


Bed and sleep should be a relief however, my cats have other thoughts and go on a rampage around the flat. I get up 3 times at very unsocial hours to piece bits of the flat back together. I really didn’t need this tonight.


So, that’s it. That’s all the day care therapy I’m going to get. I am scared about what the next week has in store for me and my mood but I’ll take it minute-by-minute.




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