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Suicidal and Ignored… Is it so for all?

More than three weeks ago my new advocate sent the following letter to my G.P. (family-doctor) and a copy to my social-worker. This includes details of my deteriorating suïcidal-ideätion. Neither my advocate nor myself have heard anything. I did however note that my anti-anxiety medication was increased by 50% when my last medications were delivered in blister-packs just over a week ago.

Safeguarding is a legal requirement in England & Wales, but it appears - at most - it is only paid lip-service. Responsibility is given to the police who have been contacted on several occasions since last December. Nothing from them either (bar a visit in the wee-small-hours several months back due to a call from the public). In the past week I went 72 hours without food or drinks, because my housemate forgot about me. I have no social-care as my local authority, Trafford Council, withdrew its services.

I struggle each and every day about continuing to remain. Almost everything causes me to stress &/or panic. I am inexorably withdrawing more and more from life. I am diminishing. I really do not know how long such fortitude can last…

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June & July 2023

Dear Dr. [G.P.],

I have been writing this over the past six to seven weeks. As you no doubt recall, it takes me a long time to type and thinking clearly is often impossible or very difficult.

DREAMS

“I am in a dark, cold, damp, steep-sided valley. My companion and myself are traipsing slowly along its course.

I turn round to see my friend has stopped. He is a couple of hundred metres behind me. Suddenly an inferno, like a pyroclastic-flow, shoots down the valley. I call out to my friend to take cover or aim for higher ground. He turns to glance at the impending doom. He looks back at me and stands his ground. I repeatedly plea for him to move to safety. I watch as he is immolated.

At this point another friend appears in a truck and goes shooting past me along the gravel track. I follow as the vehicle speeds down-valley. I note that the trackway veers sharply, almost perpendicular, from the valley-floor and thus away from the impending hellfire. However, my friend does not take the safe pass. Instead he drives his truck over the cliff-edge at the end of the valley. He is killed in the resulting explosion.

The fiery doom follows, sweeping over the cliff.

Then darkness. And cold that chills to the bone. Drizzle soaks through my clothes. And I am alone in the silence.”

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This is typical of the vivid dreams I experience almost daily. I awaken drained and shaken.

SUICIDAL IDEATION

I am plagued throughout each and every day with thoughts of suïcide &/or of friends’ deaths (both loved ones who have actually died and those who are very much alive) &/or my own dying experience. My suïcidal ideätion has not been this bad since the late 1990s. Indeed, prior to the Trafford Re-ablement Team taking over my care, I have this century rarely thought about suïcide other than for end-of-life/living-will purposes. I did warn that I feared my state-of-mind would pejorate if not dealt with.

SAFEGUARDING

Despite apprising yourself, my G.P., Dr. [redacted], my consultant, the Re-ablement Team, Trafford ASS [Adult Social Services], the CEO of Trafford, the Leader of Trafford Council, and all three [redacted] local councillors about my suïcidal thoughts, none of you took any action. This added to the individual & collective failures to act to ensure I was appropriately fed, watered & medicated, has left me untrusting of those who ought to be safeguarding me. I contacted the police. They also failed to act until an anonymous member of the public contacted them. They visited once. I have heard nothing since.

HOUSEMATE & FOOD

My housemate is unable to remind me to take medications and 2-3 times each month omits to feed me my one meal per day. Indeed, he is now struggling to even prepare & cook meals.

HYDRATION

I rarely get adequate hydration. (The hydration-system has not been used since your visit in May - as I cannot fill it and no-one else recalls to do so - nor from December 2022 to March 2023 incl.)

MEDICATION & AFFINITIES

[Redacted], my advocate, & [redacted] (my friend & ex-boyfriend) have admirably and reliably video-called each weekday & weekend morning respectively. However there was a fortnight’s delay in supplying the prescriptions as the surgery & pharmacy bounced the prescription from one to the other, neither treating the matter with any sense of urgency.

I only take one dose of the phosphate as I should require to be reminded in the evening to take the second dose. Because [housemate] never knows when he is going to be at home, mealtime is any time between 18.00 - 21.30, no-one would know when to call to prompt me to take the med. In any case, I am causing my good friends sufficient trouble without adding further obligations. Furthermore, such would deleteriously affect the dynamic of my affinities.

SYMPTOM IMPROVEMENTS

Benefits of taking the meds include the ending of body-jolts during sleep, a massive reduction in visible body tremors/shaking and a reduction in low-grade fevers & drenching sweats. Now the tremors/shakes only occur when I am excessively tired mentally/emotionally/physically.

MIGRAINES

I did not have a single migraine from 30th May to 27th June inclusive. This is the longest migraine-free period since early 2020. I had five migraines over the period 1st to 7th July, but none since - that’s tempting them! Ha ha  One of those migraines was the third or fourth time I have had to take a second tablet, but then it slowly resolved.

HR & BREATHING

My resting heart-rate has dropped from high [redacted] to typically [redacted] bpm. This is closer to where it was a couple of years ago per the Fitbit records. My heart-rate variability remains unchanged within the range [redacted] ms, with one exception. My breathing-rate has increased from [redacted] to [redacted] breaths-per-minute since medication recommenced.

SLEEP

My sleep pattern is still non-existent, but I am gradually cumulatively slumbering for longer each day (in a directional perspective - day by day is still totally erratic).

SYMPTOM DETERIORATIONS

The muscle-ticks, spasms & pulses have increased frequency and duration. Oddly, cramping has also increased. I have mouth-ulcers most of the time now. I feel really run-down. The M.E./F.M. “poisoning” sensation is more acute. I have constant toothache - in different places in my jaw. Previously my dentist advised this was related to the M.E./F.M. (I remind you that I have not seen a dentist since becoming so badly bedridden and that arrangements need to be made for a home inspection.) There has also been an increase in neuralgia in my cheek/jaw, again not in the same spot each time. Paracetamol has been sufficient to deal with, so I do not consider these attacks are migraine-related. Additionally, this year my hay-fever cum perennial rhinitis has been at its worst since the early [redacted]. Whilst I generally have throat issues during Autumn/Winter, these have continued which means sore throats, swollen & hardened glands, hoarseness and voice-loss. Previously these latter would be “morning” phenomena, but they are now occurring towards the end of the day as well.

CBT

I no longer have a “happy place” to take myself to in a meditative manner. If I ponder on happy events from the past, I quickly recall the negative consequences or subsequent events or how an affinity ended. The CBT techniques I was taught and have implemented since the late nineties, no longer work for me.

PROGNOSIS

My present feels hellish as I am all but trapped the vast majority of the time in my bed-cell and can no longer participate in my hobbies (until the change in regimen in August 2021 I was still regularly doing genealogy, learning Portuguese [my 5th language], creätive-writing, cooking, etc.). I no longer can see a future for myself. My condition has, despite shorter periods of amelioration, been following a constant deteriorating, downwards projection. From Severe ME the route can thus only be Very Severe ME. I cannot imagine anything more horrific! Whatever option to improve my situation that I creäte in my mind’s-eye rapidly degenerates into impracticality and impossibility.

DESPAIR 

Even the little things that used to give me joy such as birdsong, the pattering of rain or children playing, all now jar: the avian chorus pierces my ears due to a worsening of the hyperacusis; the dampness aggravates the arthritides; the children’s screams cause my heart to jolt and panic.

FINAL REMARKS

So, in short, I am no calmer and my mental/emotional/spiritual states are on a downward trajectory. I hope this report of the past six weeks or so is what you are after. I am sending it to you via [advocate]. Let [them] know if you need any other info from myself.

Sincerely,

Colin

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I thank the maker for the support of my advocate and that also of my ex-boyf, without whom I should have given up already. 🙏🏻🌈💕

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Suicidal? Some Agencies Won’t Help!

TRIGGER WARNING

Discussion of mental-health crises, suïcidal ideätion & suïcide attempts. Do not read any further if these subject matters may cause distress or harm.

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As of the date of publication, I have gone 170 days without medications due to withdrawal of social-care support by Trafford Council. This means nearly six months without inter alia anti-anxiety medication. A week ago my G.P. made a home-call and was here for between ninety minutes and two hours. We went through a whole slew of symptoms and conditions, but not everything; just the more urgent matters. The doctor advised me they would arrange for revised prescriptions with my pharmacist. These were to include anti-anxiety medication. A week later and still no meds. Apparently, the G.P. only sent through the prescriptions yesterday as they wanted to await my blood-tests. Given my suïcidal ideätion, one might have thought that there might be a sense of urgency. But one would be incorrect.

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Due to abuse, sexual-assaults & rapes I suffered from childhood onwards, in my late-teenage years and in my twenties, I attempted suïcide on multiple occasions, including overdoses, attempted drowning and even a self-stabbing. I eventually sought help from my then G.P., who did her best to support me.

At the end of the nineties I finally succumbed to a nervous-breakdown and received treatment from both a psychiatrist (mostly a waste of time) and a psychologist (extremely helpful) after a short-stay in a mental-health ward. I received cognitive behavioural therapy (CBT) and learned techniques to help control my thoughts, to some extent, and which I still try to implement. We addressed many issues including my abusive, overbearing & downright toxic parents. (I previously blogged about this in “Toxic Individuals; Toxic Affinities”.) My psychiatrist, my psychologist and my then G.P. all agreed that I ought to disassociate with my toxic family-members. I followed the advice. Within six months my G.P. commented that he had never seen me so confident. Indeed, I had never been so.

At the turn of the millennium, I was no longer depressed. In fact, I did not have a depressive episode again until 2006, after changing residences and moving to a new area away from my support-network. Thankfully it only lasted a matter of months. I suspect I am depressed again at this juncture (2022-3). I feel helpless & hopeless much of the time.

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Lack of Action by Healthcare

In a letter to my current G.P., dated 20th August 2021 (some 21 months ago), I wrote:

“8 Anxiety &. Panic-attacks

Anxiety was an issue I missed out, as apprised, of my long letter from earlier in the year and I noted that I needed to update you.

Because of the nature of this letter, I do not wish to go into details, but even prior to the change in SS regimen I was having increased levels of anxiety. However, since the change, my stress levels have hit the roof and I am now having a panic-attack roughly every 2-4 days, even waking up in the midst of them.

I suspect that my [medication] dose needs to be upped, at least for the foreseeable future. Please let me know what you think. I should really rather not change medication at this point as I have sufficient on my plate with which to deal. I hope that is fair.”

I again wrote to my G.P. in October 2021 (some 19 months ago):

“Anxiety & Depression

I am still regularly having panic-attacks and have started having dark thoughts. I feel bullied by Trafford ASS and this has rekindled all sorts of memories of my parental-abuse. A couple of times in the past month I have felt suicidal. Both times during particularly nasty migraines. However, I am concerned about spiralling.

Additionally, three or four years ago, you were going to organise some counselling in the Summer (May to September) months (usually my most alert time of the year). However, this did not come to pass. Perhaps this could be arranged for Summer 2022.

I definitely need something to calm me down now though and to help me stop over-thinking so much.

Please advise.”

In 2022 I revised and fully updated my spreadsheet of some 100+ current conditions & symptoms. I forwarded it to both my G.P. & my NHS hospital consultant, my two lead health-care professionals (HCPs), in an email dated 17th September 2022 (some 8 months ago) along with an email-letter detailing failures in my care régime and a serious deterioration in my health. Listed therein is suïcidal ideätion.

As far as I know my HCPs took no action. Certainly my anti-anxiety medication remained at its low rate. My anxiety & stress-levels continued to rise, with the not unreasonable assumption that the medics simply did not care adding to my distress.

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Lack of Support by Social-Care

In June 2022 (some 11 months ago) I wrote a long letter in which the following was included. The missive was sent to Trafford Council, my local councillors and the leader of the council. Later a copy of the aforementioned health-issues spreadsheet was also sent to them.

“MENTAL HEALTH

Background

I have a personal history of mental-health issues including OCD, Anxiety, Social-Anxiety, Depression and multiple suicide-attempts. I have a personal history of child-abuse, teenage-abuse, adult-abuse, sexual-assaults and rapes. At the end of the 1990s, after my last suicide-attempt and a mental-breakdown, I was hospitalised to give me a space in which to recover. From this I was referred to a local Mental-Health Trust. A wonderfully supportive psychologist spent a year using CBT-techniques to help bring me back into the outside world.

Depression

Since 2000, I have only once been sufficiently depressed to request (prescription-medicine only) support from my G.P. This occurred after moving home, the second-most stressful type of event after separation/divorce. It lasted but a few months whilst I became comfortable in my new world. As soon as I felt able, I apprised my G.P. that I was reducing the depression meds in order to fully come off them.

Anxiety

On the other hand, I have periodic prolonged anxiety, at which points I have contacted my G.P. to increase my anti-anxiety medication. Similarly, once I have felt more my normal self, I have then requested a reduction in the medication.

However, when I last wrote to the selfsame G.P., she advised me that we are all extra stressed at the moment and did nothing for me.

Suicidal Ideation

I have moved from being circa 85% bed-bound to some 95% bedridden. In Autumn of 2019, my G.P. agreed to refer me for a new inside wheelchair. My current chair is too large and unwieldy for use inside. I am still waiting for a referral. Had I had a usable wheelchair during these past couple of years, I could have gone downstairs more frequently, even out into my disabled-friendly garden constructed to support my needs. Instead I am trapped in what I cutely call my “bed-cell”!

I have increasingly been plagued by intrusive thoughts about suicide, dreams about my own or friends’ suicides and a waxing-waning obsession with death.

However, if my own G.P. is reluctant to support me, I really feel hopeless about my situation going forward.”

As far as I know they did nothing.

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Despite being so shoddily treated by Trafford Council, I wrote with some suggestions to the care-manager, the leader of the council and one of my local councillors:

“You have collectively not made one visible effort to support me. Hardly a shock to me. People that do not think it important to feed & water a caree, surely do not care a hoot about emotional, spiritual & mental distress!

My constructive-criticism here is that you:

(i) draw up standing instructions on how to d/w distressed &/or suïcidal folk;

(ii) this is widely & thoroughly disseminated not just among employees but councillors too;

(iii) get outside support from a #SuicidePrevention org to train staff & councillors.”

They did not respond to my suggestions. Nor did they take action for other clients as far as I can tell. They did however advise me that they would not communicate the issue with my G.P. Indeed, my G.P. confirmed last week that they did not get in contact with her at all, whether to discuss my deteriorating health or my alleged negative behaviours. It would seem they only play lip-service to safeguarding clients.

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So, I am left to struggle - without healthcare nor social-care - with my personal demons.

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I recently contacted a long-term friend, who valiantly came over to see me for a few days. She has agreed to and taken on the role of my advocate, so someone is at least now speaking up for me. She is shocked at the sclerotic pace at which agencies act given the seriousness of the situation.

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No wonder so many folk succeed in killing themselves.

[Image description: the author abed.]

Am I still suïcidal? On and off. I am still having emotional outbursts. I am still bursting into weeping several times per day, often without an apparent stimulus. But I am still able to talk myself out of taking drastic action.

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[Edit 30.05.2023]

@RoyalCollegeOfGeneralPractitioners @GeneralPharmaceuticalCouncil 

So, heading towards a fortnight since my G.P.’s visit (18th inst.) and still no meds. Transpires pharmacy had the prescription on hold waiting on clarified instructions from surgery. No urgency whatsoever - stuff the fact that the patient is suïcidal! FFS

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