immense pressure to stay mentally stable ish

[frenchhorn]

For those of you who don't know I am transsexual (female to male) I am on testosterone hormones and have a date for my chest surgery (to remove what grew during a female puberty and give me a male chest) However, the surgeon said she was going to ask my psychs at the gender clinic and my general psych about my mental health. It seems so far that those who I have spoken to agree that the surgery is right for me and will tell the surgeon that. However, she said in the letter to my GP that if my mental health gets at all worse then she will not go ahead.
This surgery is so mega important to me, I have wanted this since I started going through puberty, now 22.
I am feeling a real pressure to remain stable ish, however, over the last few weeks I have had episodes of suicidal feelings and have self harmed a couple of times, I have told my GP this, but I am terrified it is going to get worse as I really struggle to control my EUPD, especially the intense urges to OD/attempt suicide and self harm. If I get a strong urge not much can stop me from going through with it. Tonight I just randomly broke down crying and was tempted to OD on my meds, but I didn't. But the urges were not as strong as they usually are. I don't want to tell my GP I am getting worse again because she will tell the surgeon and my surgery will be delayed.

I feel like the pressure to remain stable ish, is making me worry a lot and get quite anxious. Anyone else felt pressure to remain stable? how did you cope with it? or any suggestions from anyone about how I can deal with it.

[Pomegranate]

When you feel urges to OD what do you want from the OD? Are you going to get treatment after? Is it a suicide attempt or a way to self harm or get some care? I think maybe the first step would be to try and figure out where these urges are coming from. You mention not telling your GP because she may tell the surgeon. That statement kind of suggests a couple of things. Firstly that you don't seem to be whole heatedly set on suicide because you are considering talking to your GP (which is a good move tbh), but also you want the chest surgery which implies something you want IN LIFE.

It seems from your posts like you get overdosing or some suicidal thoughts fairly often. That must be difficult. I think EUPD sufferers can quite often structure with suicidal thoughts. You don't need to OD or act on them though for your pain to be verified. You may get even more support from your team by working with them to move forward and ignore the thoughts than you get from ODing or stating all the negatives. Would you say you try to be positive each day and about your recovery? I doubt your surgeon would refuse surgery because of some cutting or burning because mental stability is not quite so simple, especially when you've had symptoms for quite a while. Actually being honest with your GP and asking for advice and guidance on coping strategies you could try may be a good starting point but also shows a desire to maintain stable mental health.

Has anyone suggested DBT or STEPPs or similar? What treatment are you currently getting?

[frenchhorn]

thanks for replying.
Each OD is different, most the timie it is a suicide attempt, but sometimes it is self harm and sometimes I don't know, but I just get the intense urge to do it.
I was having therapy, but me and my therapist decided to end it as I wasn't ready for intense therapy. But I have now been referred to a group therapy for people with personality disorders, so waiting to hear if they will accept me, then I will go on the waiting list.

At the moment although I get a lot of suicidal thoughts I can manage to not act on them because I can think about my surgery and how it would hurt my mum and sister, but when I get more unwell all that goes out of the window and I become intent on killing myself.

I am terrified of recovery because it means change and the unknown and also people will abandon me.

[Aubergine]

Hey Oliver.

Recovery can feel scary. There was a time when I was terrified - the unknown was so, so scary. I wondered who I'd be without the illness, as it along with all of the behaviours was part of my identity somehow. My life had become a mishmash of mental health related things, and didn't consist of much else. Change seemed so hard and so painful, that carrying on as I had been seemed like the only way.

What I can definitely say, with 100% certainty, is that those feelings got easier to put aside, and have now gone completely. Once I had decided to move forward, because I was going to end up dead if I didn't change direction, there was no stopping me. It has taken a lot of hard work, a lot of really hard work, but it is possible to manage a mental health condition without your life centring around it.

Change was weird to start with, but I started to build a life. I started some voluntary work that was completely unrelated to anything mental health, and because of this I have friends that aren't people I met in hospital. I started an OU course in something that I was interested in, also unrelated to mental health. I started to pull away from the mental health professionals, in a controlled way that was my choice, and that was a major factor in my recovery, because I didn't have to depend on them to manage me. I was managing myself.

I've never felt abandoned, because I'd made relationships with other people. Relationships that were based on who I really was, rather than those that were based on me immersed in the illness. I replaced therapeutic relationships with friendships, and I can honestly say that they're so much more fulfilling. It's hard going, especially because my confidence was dented by years of being cocooned in mental health world, but it is so rewarding. People like me because of me and that's wonderful.

Please don't think that I think it's easy, because it's not. I have a chronic mental health condition (schizoaffective disorder in my case) and that needs managing. I have to take medication, which has side effects that I have to factor in. I also have to manage my days appropriately so I don't get too tired or burn out, and I have to recognise early warning signs so that I catch any relapse earlier enough to prevent a complete melt down. Difficult doesn't mean impossible though.

Good luck, Oliver. It's a long road, but it can be done. *hug*

[frenchhorn]

Thank you for replying and telling me a bit about yourself.
I am better than I was a few years ago, when I was sectioned and was roaming the streets around about 3/4am having dramatic mood swings which would take me from manic to depressed in a matter of seconds. But I think that is my medication which has helped.

I guess I feel abandoned because, although my GP is wonderful, if I'm having an ok day, or few days she gets all positive and thinks I am better, but then a week later and I am ill again, guess that is the trouble with EUPD.

I am just hoping that I get accepted to this group for people with personality disorders as I feel that could help me.
But in the mean time it is so hard to keep fighting the urges and pain, but my surgery is really important that I am doing all I can to keep myself as well as possible.

[Aubergine]

That's OK. I'm sorry if I went on a bit. I didn't mean to thread jack.

It's good that the medication has helped and that you're better than you were a few years ago. That's really positive. :)

I'm sorry that I don't know much about EUPD. I guess you get ups and downs though? I can understand you feeling worried about abandonment by your GP if you got better. Have you explained this fear to her? Her being positive doesn't necessarily mean she thinks you are better; it could be that she's being positive in order to help you feel positive that things can change. Sometimes the reasons for people saying/acting in certain ways is not clear.

Group therapy can be really useful. I hope you are able to access the group and that it is helpful. Do you know when you'll find out if you've been accepted?

It's great that you have the goal of surgery, even if it does feel like an immense pressure. Sometimes it can really help to have something to work towards. Keep posting here, as feedback and feeling understood is really important. You can do this. *hug*

[frenchhorn]

Yeah mood swings is a sympton of EUPD.

Nope I have never discussed me fearing my gp will abandon me with her, just feel too scared to bring it up.

Well I got a letter from the group last week asking me to sign a form and write down which sections I have been on as they wanted my permission for people to look at my medical notes, so i sent that off, so I know they are dealing with my referral, so hopefully soon I will hear.

Thank you *hug*

[Aubergine]

Mood swings must be tough. Not knowing what's round the corner mood-wise, can be very challenging I should imagine.

I can understand you feeling scared. You might find that it really helps though; she might be able to allay some of your fears. Not easy though.

It's good that you're received the letter and sent off your signature. Hopefully you will hear soon so you can look to start working on things with the group.

How are you feeling at the moment?

:)

[Tank369]

This is actually a very emotional period for you considering everything with different pressures and your inner chaos because of your hormones. I go through pressures I have times that I have moments I think I dont think I can do this but you can, you can do whatever you want

[Stellata]

^ Yep. I want to iterate that being very emotional doesn't necessarily equal unstable mental health.

[frenchhorn]

thank you everyone for replying.
I am going home to my parents from tomorrow for 2 weeks, so my mum and sister will keep me distracted and will make sure I get up and wash etc, to keep me as well as possible.

[PinQ]

I know what you mean about the urges, I get them too and sometimes they are completely out of the blue. I often feel pressure to be stable but rarely live up to it. Could you speak to your GP and try and tell them that not having the surgery would be worse for your mental health? It may be that you are getting worse because you're worrying you might not have the surgery or it could just be the cycle of eupd (I know it all too well). Good luck, I hope you manage to get the surgery and feel happy.

[frenchhorn]

thank you.
Well the surgeon said in my consultation that she was worried about my mental health because she has had patients who had been mentally well before surgery on the roof threatening to jump after surgery. But my mum and sister will be there and I have told my mum the surgeons worries and she has said that one of them will always be with me at any one time, so I don't have a chance to do something like that.
I guess I am worrying that I won't get the surgery. I told the surgeon how important it is to me and said I was 1000% sure it is right for me. I understand they have to be careful, but at the same time delaying it would cause me to tip over the edge and I would probably do something very dangerous.