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Posts Tagged ‘Array’

Can Anyone Help? Technical Info

18 Dec

Hey, as I’m sure most of you are aware, I’m currently developing an app for PTSD. I have one part that I’ve written that I need to know is technically correct. Please can anyone help or pass on to someone who can? This is the info:

Thanks for this I really appreciate it. This is the text:

“If you are in a life or death situation these changes can be beneficial, but what happens when you aren’t in danger but your brain perceives you to be? This is what happens in PTSD. Let’s get technical for a minute.

The reptilian section of our brain is responsible for the millisecond planning to choose between fight, flight or freeze. The amygdala is an almond shaped part of our brain that has a role in decision making and emotional regulation. Whilst research into what happens is in its infancy, this is what researchers believe happens in PTSD. When we have a flashback, the reaction starts in the amygdala and triggers a response in the hypothalamus. This area of our brain is responsible for releasing certain hormones and controls things such as body temperature, thirst, fatigue and sleep. The hormones that are released send the amygdala in to threat mode.

Normally the hippocampus, which is responsible for the time and sequence of events, allows us to see that the threat is not in the now and is just a memory. However, the amygdala takes over from this part of our brain when a threat is perceived and it feels like what is happening is in the present and we have the same flight, fight or freeze response. 

The hippocampus is also responsible for processing memories and, with PTSD, our memories haven’t been processed properly. It is like they are stuck there and so any trigger can bring this memory back very quickly.”

Any help would be grateful received. Many thanks. 

 
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Personal Health Budgets for Mental Health – Part 2

28 Oct

This is an update after the recent post about personal health budgets in mental health. I met with both my care coordinator and woman from the health budgets department and it was decided that we should have a meeting with them as well as my therapist as my support was to be psychologically driven and so needed her input. 

When we all met the following week, we discussed how better my needs could be met based upon my health goals:

1) better crisis support to reduce a&e visits

2) support network around therapy as this was going to get difficult over the coming months when we start trauma work. 

3) help to get back to a fitness regime which was a big part of my life before everything happened. 

4) psychological help. 

In order to meet these goals we tried to think outside what the current NHS provides and so came up with the following:

1) Crisis support similar to a residential setting but without actually staying anywhere else – so having access to a service 24 hours a day as nighttime is my worst time and at the moment, I am advised to go to a&e at these times. 

2) A support worker twice a week to try and integrate me back to a standard of living and not just existing. Hopefully this will allow me to start getting out and doing things like shopping – simple tasks that just aren’t doable right now. 

3) A personal trainer twice a week to help me with my health and fitness goal to lose weight and hopefully reverse a recent type 2 diabetes diagnosis. 

4) Psychological trauma work to overcome my ptsd symptoms and move forwards. 

I must admit, I’ve found the whole process rather stressful which I know is because I’m the first in the area to do this and so a lot of questions are being asked for the first time and I’ve not really had anywhere to turn for advice on what others have done in my situation or similar. The good thing though is that I’ve realised my care coordinator and therapist both totally understand what I need in order to move forward and this has given me some renewed hope that I can get through this and maybe have a chance of a ‘normal’ life. I’ve definitely learnt however, that there is no way you can try and do this process alone, you need the help of professionals who know your situation.

I think when I was first told about this new way of working, I was worried that it essentially meant stripping away everything I was currently receiving and then buying in services. It really stressed me out thinking I would be losing relationships that I’d spent time and effort building and could I really go through all that again. I’ve since learnt that I can keep these things, like therapy, and the additional support is to help reduce costs elsewhere (like the use of a&e). I think this needs to be made more known at the outset to relieve any potential worry. 

The actual process seems a bit in the air right now, with some parts seemingly a bit backwards. For example, once you receive an indicative budget, you are able to meet with a broker to help fulfill the goals in the support plan. However, the support plan asks for information that would seemingly come from a broker so that bit had to be left unanswered. There was a lot of repetition as well in the forms and I’m not sure they are right as they currently are. 

The process though has been well communicated to me throughout and I can’t fault the people involved (my cc, therapist and woman from personal health budget department), it just feels like everyone is on a learning curve right now. Hopefully this is the start of things changing for me. 

Moving forward now, I’m not 100% how things will actually work out as I don’t know if there is anything out there that can be commissioned to meet the crisis care goal. I guess this is where the broker will come in and be able to help find anything out there. It’s quite a slow process so far, we started in back in August and so I’m not sure when these things will be actually put in place. The only downside I think is that I feel under pressure not to use a&e, like I’m wasting resources. To be honest, like most people with mental health issues, the last place they want to go in a crisis is a busy a&e department, but what other option is there? It’s where we are told to go repeatedly when out of hours. I’m hoping that this will provide me with an alternative, but what if I’m incredibly suicidal, will the crisis place not also just tell me to go to a&e? Will this actually work? I guess time will tell, but my personal concern is that I won’t speak up in crisis because I don’t want to use resources that are above and beyond the budget. Will this end up in me just being actively suicidal and in a lot of danger? I guess only time will answer these questions. 

 
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Personal Payment Budgets for Mental Health

06 Oct

My area has just introduced personal payment budgets within mental health (it already exists for social and health care). This means that basically they look at how much you have cost the system over x amount of time and then allocate you a budget to spend on services that can best support you in order to reduce the overall cost. Sounds ok on paper doesn’t it but I’m part way through the process as the first person in my area and I’m getting a bit stressed by it all.
There are many questions I have but no one within my community mental health team knows the answers because it’s brand new.

I had to submit an expression of interest form which looked at my goals to get better. I took a three point approach:

1) receive psychological help

2) receive support when in crisis

3) receive support around weight loss and health goals to enable me to feel more confident to go out

This was taken to my local Clinical Commissioning Group (CCG) who have said it needs more information before releasing funds. I am therefore meeting with my care coordinator and the woman in charge of the process to try and put it down in more detail.

The questions I have are mainly around what I’m currently receiving. For example, my therapist who I see once a week might not be able to see me anymore because a) I’m supposed to ‘buy in’ a therapist and they aren’t set up that way so it wouldn’t work with them and b) my care coordinator seems to think twice weekly therapy sessions might be a good idea but she only works part time. I honestly don’t think I can go through with building a new relationship with another therapist.

Also, I’d lose the crisis services and have to buy those in as well but who knows when they are going to hit crisis and so how can you buy that in in advance? For me, most of my problems occur out of hours – but they’ll be no access to duty so what then?

I know the aim is to reduce a&e visits and hospital stays, but is there actually anything out there at the moment that provides that kind of support 24/7?

I’m really quite scared about the process and what I’m going to end up with, but in some ways I feel a bit rail roaded into it because I’m the first one and so a lot of attention is on the case.

If anyone has any experience of their own personal payment budget purely for mental health, what have you spent yours on?

 
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Why Bother?

21 May

**TRIGGER WARNING – TALK OF SUICIDAL THOUGHTS**

I have felt my mood dipping for the past few weeks and I’ve done everything to try and stop it happening as I said there was no way I was going back to the dark place where nothing seems worthwhile. And yet here I am, feeling extremely suicidal and not having a clue what to do next. 

I’ve not seen my care coordinator (cc) for a few weeks now but we have been in white regular phone contact until this week. Last week I asked for some prn (as needed) medication and was given promazine to get me through the weekend with the view to seeing my cc at the beginning of the weekend for support. 

She called me on Tuesday and I told her I was really struggling and that I was feeling like I just wanted to curl up and die. She told me to go away and think about that. That left me feeling pretty crap and very unsupported. After I told her how I was feeling, there was no mention of an appointment in the week. 

I managed to get myself (one way or another) to Thursday evening when I felt very dissociated and unsafe. I called a newish number that is running across the whole of the trust which is a mobile number stationed about 25 miles away. She told me to distract which I’d been doing all week and was at the end of my tether. So a bit later on I called the out of hours (ooh) social worker for my area. He was really good, had worked in the same office as my cc and so knew my history and me. He helped to ground me and said he’d let me cc know I’d called and recommended I be seen face to face with someone the next day. I felt a tiny bit of hope. 

I waited all day Friday to hear from either my cc or if she was busy, duty. Surprise surprise no call came. This just fed in to my thoughts of being worthless and that I shouldn’t be alive. I started planning my death and even tweeted local police to apologise for an officer having to find my body (I knew their twitter account isn’t looked at over the weekend so had no worries about any repurcussions). 

I was really confused and thought I’d try and get help one last time. I called the ooh social worker again and this time she told me to go to a&e. If I didn’t go, she said she’d send the police (I hate being threatened like that), so off I went. This was about midnight. 

As expected for a Friday night, a&e was really busy and mainly full of drunk people which was really triggering for me and I was on the verge of a panic attack. An hour later I was seen by the triage nurse and I told her ‘I want to die’. She took my blood pressure and heart rate, both of which were high and she told me how anxious I looked. I explained it was the waiting room that I struggled to be in. She then told me I had to go back out there and wait to be seen by a doctor (the waiting time was 3 hours) and to be passed medically fit before someone from psych could see me. 

I asked if I could just be seen by psych as I hadn’t anything physically wrong with me and it would be a waste of everyone’s time. She said it was policy and I had to wait. She gave me a drink of water and sent me back to the waiting room. I lasted a whole 5 minutes before telling the receptionist to cancel me and I left. 

Even though just 5 mins earlier I had told a medical professional that I wanted to die, there was no problem with me leaving a&e or no follow up. So here I am today, feeling highly suicidal, frustrated with the whole mental health system and extremely unsupported. 

Who knows if I’ll still be alive by Monday when the office hours of mental health will be back open! 

 
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Voices with PTSD or is it BPD?

22 Sep

**TW: Cutting**

On and off I’ve heard this voice; its external, it’s male and it calls me names. That was until this weekend when it started to do more than name calling, it began telling me to do things and if I didn’t there would be consequences. For example to cancel my appointment with my community psychiatric nurse (cpn) as I can’t trust them. If I didn’t do this, it said it would hurt me. It didn’t say how, but in such a way I believed it and do I didn’t go to my appointment. My cpn called and I decided to test the voice and explained why I wasn’t there. She told me I had to keep challenging it by doing things (like getting my meds for example) and to ignore the consequences it spoke of.

And so this afternoon I did. I went and got my meds and instantly I was told to cut myself. Now I tried cutting right at the beginning of my illness because I didn’t know what else to do but it hurt and I didn’t like it (this was about 5 years ago). I only have 1 tiny scar as they were very superficial cuts. I don’t want to cut myself but all I’m hearing is name calling and telling me to do it to stop it and so now the thought is in my mind. 

I’ve tried looking in to PTSD and hearing voices but I’m not really finding anything about it and was wondering if anyone else deals with similar and what they do? I’ve tried telling it to go away and imagined I’ve got a volume button that I’m turning down but it still prevails.  

I’ve heard more than once it being mentioned that it’s to do with bpd and I also wondered if anyone had had any dealings with this? My psychiatrist said it isn’t psychosis and the voice really only makes itself known when I’m in a high state of anxiety (or that’s what I’m told by services). 

I’m just looking for other experiences I guess. Thankyou. 

 
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Hospital

25 Aug

So here I am again, on a psychiatric ward listening to the usual alarms going off, people kicking off and general hum drum of life on a mental health ward. 

I don’t want to be here, I don’t think I should be here but the choice was pretty much taken out of my hands; go informal or we’ll section you. 

Just so people realise, there is no therapy in these places – the sole purpose is to keep you safe. Now the fact I took an overdose on Sunday (now Tuesday), it’s a bit reactive wouldn’t you say? 

I want to go home I’m in the mixed part of the ward so the room next to me is male. I’ve locked my door but just feel hyper vigilant and unsafe. 

I’ve been ‘clerked in’ where they take your bloods and you literally go over everything the consultant has just been over with you including the reason you’re there (erm because you made me). 

I’ve just asked for some prn (which means as needed) promazine for my anxiety and to try and stop the thoughts ruminating but been told it’s not been written up yet – seriously, what is it with this place, I couldn’t even get paracetamol for a bad headache earlier. 

This post has been long coming, I’ve gone further and deeper in to the black hole. Sorry if this is where it cut off last night, I pressed publish instead of send when I gave my phone in to be charged. 

So it’s now 6.15am on Wednesday morning and I’ve been woken up every 15 mins by them switching my lights on to do observations. So now I’m tired as well as ratty!! Im just going to have to play ball until I can get out of here now! 

 
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