As I have already indicated, I’m not very good at self-care, but over the years I have proved to be exceedingly good at self-harm, whether emotional, psychological, spiritual, or physical.
It might sound a tad silly, but one of the challenges when it comes to my engaging in productive self-care is that I’ve never been very good at any form of self-care at all.
Seems a long way back now – around 2003 – I had the misfortune to be prescribed fluoxetine hydrochloride by my GP. I blame Cushla because it was her idea to get medication to enable me to sleep through the night. Blaming Cushla is a hugely unserious (and unfair) quip even though it was her kindness that set this part of my journey in train.
Finn was around eighteen months old and still feeding from Cushla (this in itself is another story) and I’d taken it on myself to be the night watch. He’d wake up, I’d get up, change him, and give him to Cushla for sustenance, then I’d go online until the feeding was done, change him again if needed, and, usually, we’d then watch The Lion King until he was ready for sleep. We didn’t know about his autism at that stage but, in the light of what was to come, it all makes sense.
After weeks of this I was a bit of a wreck – full time job, two master’s papers, and this night activity on top of the rest, and Cushla decided that she could do the night shift, and I could sleep. Nice idea, but when Finn woke so did I and the plan just didn’t work, in part because I liked looking after him and doing my bit.
Next came the suggestion that I see my doctor and get some meds to help the sleep process which I did. My doctor was great. He’d guided me wisely through the counselling process that set up my transition and he was just as careful with this, making sure that the meds he prescribed didn’t react badly with my hormones and blockers. Having don’t his die diligence on my behalf, he prescribed Fluoxetine Hydrochloride.
Fluoxetine Hydrochloride is sold under the brand name Prozac, among other names too, It’s an antidepressant medication of the selective serotonin reuptake inhibitor (SSRI) class used for the treatment of major depressive disorders, anxiety, obsessive-compulsive disorder (OCD), panic disorder, premenstrual dysphoric disorder, and bulimia nervosa, none of which I had to any great degree. It is also approved for treatment of major depressive disorder in adolescents and children 8 years of age and over.Again. not me. It has also been used to treat premature ejaculation, certainly not me. Fluoxetine is taken by mouth which makes it really convenient.
It’s also a relaxant so logical for those with sleep concerns.
Common side effects of Fluoxetine Hydrochloride include loss of appetite, nausea, diarrhea, headache, trouble sleeping, dry mouth, and sexual dysfunction.
Headaches and dry mouth, for sure. No issues with the rest.
Serious side effects include serotonin syndrome, mania, seizures, an increased risk of suicidal behaviour in people under 25 years of age, and an increased risk of bleeding.
I’m not under 25 and I wasn’t then, but I certainly experienced an increased risk of suicidal behaviour, and an increased risk of bleeding though this latter was entirely self-inflicted.
These side effects have been updated since 2010, before that there was no mention of an increased risk of suicidal behaviour, and this is a very good thing. The idea that anyone with a brain would knowingly prescribe a drug that increased the risk of suicidal behaviour to a young person who was depressed and suicidal anyway is beyond belief but that’s exactly what was happening.
Two friends lost teenagers in exactly this manner.
At that time, it’s my understanding was that the available pharmacopeia didn’t define what the psychological side effects of these drugs were. These side effects were known but couldn’t be proven and consequently publicising them risked litigation, so they stayed in the shadows.
For some young people and their families, this information came way too late.
My subsequent personal research revealed that this drug had a troubled history, a history of exacerbating mental health issues, especially in the area of suicidal ideation. I am a suicide survivor but, by 2004, this had ceased to be a serious issue for me.
Initially, my issue with the drug wasn’t related to my own mental health, but it quickly became one. We had a new baby; I was doing two papers for my master’s and had a full-time job. The negative impact of the drug on me, and as a result Cushla and Finn, added another serious problem to our existing challenges. Cushla suggested medication to help me sleep through the night while she took care of the baby – a great idea – but this otherwise ‘great idea’ had hideous and unintended consequences.
The good fit between the drugs, my sleep, and a calm and happy family life that we had anticipated simply didn’t happen. After a couple of days, I began to seriously self-harm, cutting myself with a craft knife and other blades. I became violent. Cushla took out a Protection Order against me without knowing what that meant. I was required to undertake 12 weeks of a men’s anger management course. I went to one and it was awful. The system didn’t – still doesn’t – understand gender identity and Cushla found me standing on an overbridge barricade ready to go off following that session. I didn’t go back. My failure to attend resulted in threats of three months in gaol but these didn’t work. I would not go back. Eventually the threats stopped but the cutting didn’t.
Cushla and I were supposed to live apart. We did. For one day. We stayed together in our home and worked it out. She was amazing. So was Finn. I did my best. Court officers visited. I hid in the bedroom.
Work was complex. The need to self-harm, to cut, was relentless. I was caught by my boss, in a toilet with blood everywhere. He cleaned up while I ranted angrily in my office. He found me a counsellor paid for by the university. I went once. The counsellor was an evangelical Christian and didn’t believe in people like me. Mind-numbingly stupid but he gave me great advice during our brief meeting: ‘when the need to cut happens, draw cuts in red pen, bandage first’. Good advice. We shook hands and that was that.
This went on for five or six weeks, By then I had over 1000 cuts on my body, our family was falling apart but we hung in, we stayed together, all while we waited for the medication to kick in.
We trusted that it would work out.
It didn’t. It got worse. Much worse.
Fortunately, a friend phoned me at work and asked, innocently, whether the sun had come out. I said ‘no’ and her response was ‘go back to your GP. Straight away. You’re on the wrong medication.’
She was adamant. She’d been there. She knew.
Coincidentally, at the same time, a Time magazine was mistakenly delivered to our post box and in it there was an article from Australia about a woman whose circumstances were almost identical to mine. It was an eye-opener. Same drug. Same outcomes.
I went back to my GP with the research I’d located. He instructed me to come off the drugs but not immediately as the drugs have a half-life and can continue working in the system for up to six weeks.
Good news, but not quite.
It was the start, however.
I survived three serious suicide attempts, my body is covered in scars as a result of my actions and this ill-informed prescribing (not the doctor’s fault), and who knows what psychological damage has been done to Finn, to Cushla, and to me. It’s not fun to come home from work to find your spouse at death’s door in a blood-soaked bed, or perched over a motorway ready to go off.
So, when it comes to self-harm, I have a fairly good idea of what’s involved. I had never cut myself prior to this nor have I done so since, but there are many ways in which poor self-esteem can impact, and society just being a bitch can challenge who you are, and I certainly have an extensive track record, and know plenty of knowledge about that.
I would like to say that 2024 was a clean slate year but it wasn’t.
The periods of depression and confusion about who I am, and what comes next, has been exacerbated by government threats and the international situation as regards, transgender people. It’s been awful and it’s unlikely to get a new better.
We have to gird our loins, hold hands, and fight for some sort of positive change.
It won’t be easy.
dykiegirl 