There's like this Step model thing. But even then the lines are kind of blurry. You see, in my case at least, although my primary diagnosis is depression, it is classed as complex depression - because of the anxiety &etc. Plus that medication's never really stopped me feeling depressed. But I don't have all the other factors at that Step. Hmm.
Apparently there are no NICE guidelines for any dissociative disorder
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There's like this Step model thing. But even then the lines are kind of blurry.
Where did you find that?
I guess lines have to be kind of blury... e hard to determine where to put the lines, and it's likely that noone will fully fit into any box
I Googled Nice guidelines depression. I had to open it as a Word document as the PDFs made my browser freeze. Link here.
I'm continually bewildered and intrigued/curious at how they always seem to determine severity of mental illness by it's impact upon the physical body - self harm, self neglect and the like. I mean, I've done the whole not looking after myself, not eating, hurting myself even under the counter at work and in the loos in every breaktime thing. But in actual fact, as I've become more self aware and aware of my feelings and everything, in many ways my distress can be more now I'm more 'in' myself because I'm no longer numb. This is where the dissociation complexity fits in, I guess. As I recover I can feel more ill and frightened and violent etc than when I was most sick!
Am I making sense? Disclaimer - I am talking reflectively and not conclusively here. I am thinking aloud as it were, not judging anyone or anything.
makes sense. But I think generally when we are really ill we often do not see it ourselves, that's why often it will be those around us who'll notice first
I agree, although they won't always say/do anything. I know my parents were like that when I was younger.
Another thing I need to add is that as I was growing up I was strongly and firmly taught to 'carry on regardless'. So I only ever had one day off sick in the whole of my secondary education, despite the hell it was for me at school. So I carried on teaching even when I was clearly ill, as well as failing. So, even now, I go into work on days I should really be at home, when I'm really feeling too vulnerable and volatile to face the public. And even those few occasions when I've actually been physically sick with a bug, I've only had minimal time off work to recover.
I am learning to take better care of myself, but it's a long journey, as the 'struggle on even when you feel you're dying' is so deeply embedded in me. Maybe it's my parents' generation - born just before and at the beginning of the 2nd world war. Maybe it's how you survive in a dysfunctional family where domestic violence was rife. Maybe it was the 80s Thatcher work ethic. [My father being a staunch Conservative.]
I know it might sound like an excuse to some, but it's a contributing factor I feel is important.
I know it has both a positive as well as an unhealthy side, the 'keep calm and carry on', 'carry on regardless' thing.
I don't think it's your parents generation, based on the fact that my family was similar...
My family expected me to preform well and act normally no matter what was going on. They used to view emotion as weakness too, emotion and "giving up" (which is what they called not doing something due to anything bar eing in hospital or dead) were both signs of weakness to them, and weakness had to be punished
To be honest I am incredibly unsure of what evidence of self neglect is. Because I am a nosy parker I read my notes over my doctors shoulder when in an appointment and every single time he writes "no evidence of self neglect". Which quite frankly hasn't always been true, I've talked about not washing my hair for two weeks with him and about living off crackers and cupasoups because i couldn't face cooking. I've had appointments 3 days apart where I've worn the same clothing because I hadn't taken it off or got changed. So as for what self neglect is in terms of depression I think it must be pretty extreme, such as not eating at all and maybe being incontinent.
My mum used to wear an old skirt covered in gravy stains which she never washed and an old torn blouse indoors at home.
Although she never sought treatment or anything.
The sticky point for me I think is that a major part of my depression is anxiety, 'agitated depression'. This leads to different self care problems, and the whole thing of walking in the road a lot of the time because noone seems to give me enough room to walk comfortably on the pavement - this is sort of a combo. of paranoia and severe hyper-vigilance I guess. But doesn't fit any boxes because it's not true psychosis.
I'm not even sure I've told my GP this. Although my therapist knows.
Sometimes I get annoyed at the way some of the NHS's criteria decentivise trying your hardest to function. So someone who gave up at the first hurdle would automatically be judged as iller than someone who put every effort in trying to continue. So either they decentivise making an effort, or they wait until a person is completely exhausted and broken down before they realise the severity of the situation. And I do wonder how often earlier interventions would lead to quicker recovery and better outcomes.
And I've not been to the dentist for over 20 years, but my teeth are in fairly good shape [a miracle I know!]. So noone would count that for anything really. Again, I don't think anyone knows apart from my therapist, who does nudge me about it periodically, pointing out that that's quite severely self neglectful. It's not so much a depression thing for me, but again, anxiety [and finances....]. Orthodontic treatment I underwent in my teens was painful and intrusive and invasive, and has left me really scared and everything. Plus the whole thing of a mouth being a very private thing that you don't just let anyone into. [Yes, I've explored that a little in therapy...]
I think you're supposed to see a dentist at least every six months, and a hygenist as needed. Me, I'm approaching 40 and haven't been near a dentist's since I left uni when I was 22, perhaps even before then.
My father hasn't been to see a dentist in about that time either. His teeth are in pretty bad shape.
But then degrees of neglect pervade my whole family. Hmm.
I think apparently it's now once a year if your dentist thinks your teeth are pretty good.
See I stopped going to the dentist when I was in 6th form as I'd heard that 1/3 of bulimics were diagnosed by their dentist and I didn't want to get found out. Took until late last year for me to get up the courage to go, but again it wasn't about self neglect. Ha the more you think about it the more variation in what is a normal level of self care is.
I haven't seen one since I was about 10... I really should as I've had a chipped insisor for 3 years, but I can't afford it... and the idea of some guy touching me and going in my month terrifies me...
I have the whole self-neglect thing on my notes, due to such things as not eating unless I get made to, and never doing anything for myself (cooking, drinking, getting dressed, etc.) unless someone makes me.
I think though as it's so subjective each professional will probably sort of have their own ideas of what constitutes self-neglect
I'm terrifed of the dentist, and yet I go twice a year. I like to have my teeth checked as it would be even more terrifying if there was a problem that went untreated and got so bad that when I finally got it seen to it was really painful and traumatic.
shadow-light my dentist is female and she is on the NHS so I only pay about £15 per check up. I told her I was nervous and she reassured me and said if I wanted her to stop I just had to raise my hand.
Isn’t it funny how day by day nothing changes but when you look back, everything is different…
you once called your brain a hard drive, well say hello to the virus.
my teeth are terrible from periods of extreme self neglect.
& it's the one thing that upsets me the most i suppose.
i think one thing that is almost not noticed with my care, my level of self neglect has been very high at times (soiling the bed, i cringe now), yet they don't take into account when i am vaguely looking after myself.. how much effort is in it, such as losing the toilet.
although in periods of illness, am i the only one who has managed to make something to eat & then gone "i can't eat it". because making it (even like a sandwich) has been so draining?
I've bought food, especially lots of vegetables, and then not even got as far as cooking it, so having to throw it away, and eating junky comfort food instead.
I'm better at the whole eating thing now - for years my parents would do my food shopping for me, because they didn't trust me to eat properly of my own accord.
I've bought food, especially lots of vegetables, and then not even got as far as cooking it, so having to throw it away, and eating junky comfort food instead.
I'm better at the whole eating thing now - for years my parents would do my food shopping for me, because they didn't trust me to eat properly of my own accord.
though not sure if that's a self-neglect thing or a left over ED habbit type thing
