Please can someone help me to organise my messy brain?

What is wrong with me? My head is messy, I have thoughts that jump from one idea to another with no connection. It is an effort to perform simple tasks and to make sense of things.

I have thoughts and ideas that I don't want and they seem to come from nowhere. I am looking for signs that will help me to decide whether to self harm or not. So far, there have been about the same of each. I don't know what the signs are until I notice them. They may be words that stand out at me on an advert on a bus shelter or a newspaper someone is reading. Or events or situations that happen.

How will self harm help? It has to be something major, like another burn, as only extreme pain will snap me out of my confusion back into reality. I feel out of sync with my surroundings; the world seems faster, louder and brighter than it should be. When I'm outside, I am fearful and nervous. At home, I am more easily disturbed or irritated by small things.

Being at the Day Unit today helped. It is quiet there, but I'm not on my own. I am trying to use the therapy and be hopeful that it will help. It's all I have. If it doesn't work, then I don't know if I have any more options.

First day

First day at the Day Unit. Only one group today as they are running a reduced timetable over the Christmas period. There were 3 other patients in the group; I think in total there are 6 or 7 patients at the Day Unit at the moment, but attendance fluctuates and it's rare to have a full group.

It was an "Exploratory Group" today. Not exactly sure what we are meant to be exploring or how we are meant to explore it. I am a group therapy veteran, having done two and a half years previously at the Day Unit, plus other therapy groups since. So I know what to expect. But it was still draining, even though I didn't talk much.

So I won't write much today as my head feels so full, and yet I feel empty at the same time.

Am I doing the right thing? That is the question that keeps coming into my mind. What the hell am I doing back at the Day Unit? It's all happened too quickly and it wasn't my idea. I just went along with what Superstar psych thought was for the best. Now I'm not sure. But what else is there?

Back to the Day Unit

I met with my psychiatrist (who I shall now refer to as Superstar psych, due to his reputation and status in the field of PD) and he has arranged for me to start at the Day Unit next week. Initially, I was relieved as at last, something was being done and I needed something intensive and immediate. But I am also disappointed in myself and see it as a kind of failure, as I have not been a day patient for seven years and hoped that I would never need to return. Yes, it is better than being an inpatient, which would be pointless and would have limited therapeutic value. And if I continue self-harming in this way, the consequences could be serious.

The Day Unit is a specialist PD service, based on group therapy following the Mentalisation Based Therapy model. It runs from 9 to 2.30 on weekdays, with 2 groups a day and one individual therapy session a week. It has changed since I was last there - there are much less patients now, probably only about 6 rather than 12. I know two of the staff quite well, and my therapist is someone I have had groups with in the past.

There is an art room that I can use outside of group times, and although my creativity has waned during this depressive period, maybe I can start to do some art again.

The therapy can be intense and difficult at times, and there is often conflict and tension in the groups, as we are encouraged to explore the impact we have on other group members, and the impact they have on us. Most of the patients are in their 20s and 30s and have the diagnosis of BPD. I hope I am not the oldest, at the grand old age of 36.

I start on Wednesday, after the Bank Holidays. Unil then, I have to manage by myself as the service is closed from Friday, and Superstar psych is on leave for a couple of weeks.

The damage I do *trigger for self harm*

Why do I not take the harm I do to myself seriously enough? I remember a therapist telling me to imagine that the these injuries were inflicted by someone else, to someone I care about. How would I feel? Not only would it be a crime but it would make me angry, distressed and wanting to do anything I could to help.

When it's me doing it to myself, I find it hard to feel anything other than annoyance at myself, and sometimes regret. Sometimes I'm even strangely satisfied with the injuries, if I feel they are "bad" enough. But if they are too bad, it scares me and I do worry about what will happen if one day I go too far and do damage that is permanently disabling. It's too late to worry about scars, about 20 years too late. But if I were to lose the use of any part of my body, especially my hands/arms, I would be devastated.

My latest bout of self harm has scared me as I haven't burnt myself for ten years. I have cut myself, but managed to stay away from A+E for self harm. But the burns are too serious to treat myself - I hoped I could, but as there are now 3 quite large 3rd degree burns on my arms, I am facing months of dressings at the Burns Unit. I didn't want skin grafts, and the Burns Team were concerned that I may not be mentally well enough to cope with surgery. So it's goodbye arms, hello bandages.

I don't actually like the blood and gore aspect of self harm so every time I see my arms, I feel disgusted and freakish. Part of me wants to wake up tomorrow and to be completely healed. But another part of me wants the pain, the punishment, the hospitals and the care I receive.

I hope this is just a blip. My psychiatrist has upped my meds, and I am considering becoming a day patient if things don't improve, just for a couple of months to get me back on track.

I am not sure if I'm mentally "unwell" or not. I don't know how to describe how I'm feeling exactly, and this frustrates me. I have days when I'm lethargic and feel disconnected from the world. I have days when I am agitated and fearful and anxious. I seem to flip from one state to the other, maybe a couple of weeks of the lethargy and then few days of the agitation.

Today I'm lethargic. This is safer - I'm more likely to harm when I'm agitated. Today, I haven't got the energy.