I’m just going to relate something that happened to me today. I’ll warn you now that I describe self-harm.
I was taken by ambulance to the local hospital’s Emergency department this morning. I’d phoned the non-emergency number the night before, discussed various symptoms, and they said they were dispatching an emergency ambulance.
Over eight hours later I was awoken by loud knocking at my door: the paramedics. They were very good, thorough, and after a physical exam transported me to the ED for further assessment. After being booked in I was led to the waiting area in the department reception.
I expected a long wait: I know how the NHS is stretched to breaking point because of years of under-funding and poor leadership by the politicians in charge. And a staffing crisis made so much worse by the heightened atmosphere of hate towards immigrants, especially since the EU referendum.
But enough about that.
I was sat there, on a seat that was slightly too low, in a bright fluorescent strip-lit room devoid of soft furnishings that might absorb any noise, in among people all talking, with a radio intruding in the background, and interspersed with the sounds of doors, footsteps, announcements. Smells of people, of flowers on the Reception desk. Sudden loud noises triggering instinctive fear.
I was tired. I’d sat up waiting for the ambulance until I could no longer keep my eyes open. I had reluctantly got into bed, fully clothed, because I felt chilled and tired: I was not there 3 hours before I was awoken again. I had been nil-by-mouth since 11pm the previous night. Not even a sip of water.
To say my thresholds for sensory tolerance were low would be an understatement: tiredness affects it greatly and I was exhausted before I started, on top of feeling ill.
I can’t say for sure how long I sat there before it became unbearable: my sense of time was distorted. But after a while I had to ask at Reception if there was somewhere dark and quiet I could sit. There wasn’t anywhere ideal, but she very kindly switched off the lights in an alcove where the payphones were situated and I sat there.
It was a big relief, and I relaxed. Didn’t last or course: only a temporary respite because the effect of a sensory load is cumulative. It was if I’d stood on a step to lift my head above rising waters, but still not escaped the flood. And in due course I started going under again.
I put my earphones in and played music loud to drown out the ambient noises. It helped a bit, another step up to keep my head above the water. But again it was only temporary and after a while I was becoming increasingly distressed again.
Running out of options, I turned to the next tool in my bag. Or rather my pocket: a set of keys. Started scratching my arm, causing pain to give me something to focus on against the sensory uproar. That photo above is the result: I rarely draw blood. It’s about inducing pain rather than actually damaging myself. But less harmful alternatives like pinging an elastic band or digging my nails in aren’t usually intense enough.
Again this was only short-lived relief, and I found myself becoming more and more desperate. I hit myself in the head, banged my head against the wall, cried.
I was close to screaming when I began to pick up a calm voice close to me. I realised somebody was saying, “Hello. Are you all right?” It was one of the Receptionists, the one I’d asked about the lights earlier.
It’s something I’ve found before: if I have somebody I feel is safe I can focus on them and it helps calm me. It’s why I can handle a lot more if I’m not alone. When alone, all my attention is focused inward and anxiety rises.
Feeling any degree of safety helps, and this woman helped me, talked to me, supported me. I could feel my anxiety decreasing, draining out of me and leaving me exhausted.
So exhausted that I felt a strong need to lie down, so using my bag as a pillow I lay on the floor. That brought relief because in that position I was able to relax all those muscles needed to remain upright on a seat.
I was so exhausted I might have slept, even in that environment, had the doctor not arrived a short while after to take me into a treatment room for assessment.
Sensory overload is a powerful trigger for anxiety, the two feeding each other and mounting rapidly. Coping mechanisms only buy a little time: in the end you either get away from the causes or you get overwhelmed and melt down. I was on the cusp: if the Receptionist hadn’t been able to ease my anxiety with her presence I would have lost my shit in a big way.
I hope this helps highlight the need for sensory-friendly areas any place where neurodivergent people have to spend time. I left the ED in much worse shape than I was in when I got there. The environment harmed my mental and physical health: that is not acceptable.
We deserve better.