So, I've managed to embarrass Kumari utterly. (Again.) This is not an uncommon thing for me, but this time it's because I wrote out a 3 page, nicely collated and stapled set of rules for anyone who takes up Kumari caretaking (for an afternoon or overnight). I particularly tried to emphasize the severity of the symptoms at times, and that particular care should be taken with all of them. Kumari is strongly considering never leaving the house again out of embarrassment.
Yessssss.
Anyways, here's our full set of Kumari-Keeping rules, minus contact information! It has a pretty good rundown of a lot of her symptoms, and a few of the ways we try to treat them, or prevent them from manifesting as much as possible. I of course removed the emergency contact info, but otherwise it's unchanged.
Rules of Kumari-Keeping
Important rules to keep in mind while watching Kumari. She can hide it well, but the BPD and comorbid disorder symptoms are very severe, and though they don’t all manifest at once, there can be problems with two or three at a time. In addition to the BPD (which largely makes her highly sensitive to emotional situations or even misunderstandings) Kumari often has actively suicidal tendencies, clinical depression, anorexia (sometimes with bulimic tendencies), binge eating, other self-destructive tendencies (desire to return to alcoholism, engage in unhealthy sexual activities or start smoking), and high levels of anxiety about all of these issues. THESE CAN BE LIFE-THREATENING.
The most important aspect of taking care of Kumari is simple supervision. Keeping a close eye on her means PLEASE SUPERVISE KUMARI AT ALL TIMES! Things to look out for are described below, but actively watching her keeps her mental state better, and makes our job as caretakers much easier. And the likelihood for a major emergency is much lower with some vigilance.
Nighttime is a much more dangerous time for Kumari, because most of her symptoms get worse in the evenings. Make sure Kumari is home by 11:30 to get her meal before bedtime, and if she’s staying with you have her start winding down around then. Meds should be taken as close to midnight as possible once all of her food is eaten and she’s brushed her teeth, so hopefully she can be asleep by 2 (when often things start to get really bad). Be especially vigilant in the late afternoon/evening though.
Prohibited From Kumari
-Sharp Things- This is one of Kumari’s biggest problems right now. Keep her away from sharp things (particularly razors) at any cost. Hide them before she comes over to your house if at all possible. Otherwise, keep track of them and make sure she doesn’t hide any of them on her person. Self-harm is an extremely strong compulsion for her, and she feels much safer in some ways if she knows she has something to hurt herself with, so keep a VERY sharp eye out for anything like:
-Razors (safety or otherwise)
-Scissors or knives
-X-acto or boxcutter blades
-Thumbtacks, pushpins, needles, any other sharp metal objects
-Broken glass- avoid glassware/breakables
-We’ve even had issues with things like fake nails, so err on the side of caution.
Also keep an eye out when in shops or stores for her trying to pocket safety razors, this has occurred before and should be watched for in the future.
-Other Self-Harm- So far this has not been as big an issue as Kumari’s favored cutting habit, but when her other self-harm outlets are blocked and she doesn’t know how to cope Kumari does tend to punch the ground, walls or other things as a form of self-harm.
-Alcohol- Alcohol is a depressant, which is INCREDIBLY dangerous for an already depressed person, especially one on medication for it, to have. Kumari has fun drinking, true, but it will cause problems with her medication and some of her worst points are when depression hits hard.
-Drugs- Well this just goes without saying. No illegal activities, of course, cause paying for fines is expensive, and it’s yet another self-destructive outlet that will just cause problems. Don’t do it.
-Smoking- An old habit of hers, not kept up for very long, but it’s another form of self-destructive behavior that occasionally resurfaces. She told me specifically when she left Cedar Springs to not let her start smoking again. Therefore, don’t let her start smoking again.
-Running Away- Occasionally in high-stress situations Kumari will run away. Literally run in a random direction to try to find someplace to hide, usually to try to cut. DO NOT UNDER ANY CIRCUMSTANCES LEAVE HER OUTSIDE UNSUPERVISED, ESPECIALLY AT NIGHT. If she does this she’s usually found something to hurt herself with, and this could be a potential suicide scenario. This is the worst-case scenario, and if you can’t find Kumari immediately text myself, Trevor and Anna and we can try to contact her- she often tries to call Anna when she’s at her lowest points anyways and will likely answer for her no matter what, and she can tell us what’s going on as well and help locate her. If Kumari has run away and it’s been more than 30 minutes, she’s not answering her phone, and we can’t find her, it’s time to call the police to help look for her. Don’t be afraid to call emergency services in general if the situation calls for it.
-Avoiding Eating/Throwing up- This has been a big issue recently, as anorexia is another form of self-harm that’s very common with BPD. Avoid using guilt tactics when confronting her about eating, because anorexia and associated disorders are a manifestation of control issues,
-Be very firm about how much/when she should eat. (Look up calorie amounts, at least 300 calories a meal, preferably 400). These can come from anything, she just needs that many calories per day.
-Keep a close eye on her bathroom visits until 30min-1hour after she’s last eaten, especially when medication is being taken. Eating causes her a great deal of anxiety and there have been bulimic tendencies recently, and if she actually manages to throw up what she’s eaten recently/her medication she needs to eat again.
-She absolutely has to have at least 300 calories with her evening medicine, the lithium she’s on causes gastrointestinal problems if not eaten with a meal. She waited 3 hours once after having skipped her medication, and it caused her a bad stomachache for several days.
-Actually watch her eat. She should not be able to get away with rearranging her food on her plate or hiding it. Make sure she actually gets an adequate amount of food. Healthy food, if possible, but we’re working on getting her to eat at all right now.
-Skipping medication- Kumari has morning and evening medication. Occasionally she’ll forget her morning medication, which causes a bad bout of depression later in the evening since her morning medication is her antidepressant. This should be taken with food shortly after she gets up. (Once again, at least 300 cal.) The bigger problem has come from her intentionally skipping her evening medication to try to run away later at night. Watch her quite closely around bedtime, especially if she’s shown any warning signs like obviously suicidal thoughts, extreme self-deprecation, or has recently interacted with parents at all. Watch even closer if she very suddenly seems chipper again. Make sure she actually takes her medicine (not pocketed/hidden/flushed down the toilet later) right before going to bed.
Short guide to general care
-Daily caloric intake is 1500 calories for weight-loss. Any less is detrimental. Make sure at least 300 are eaten with breakfast and medtime, the others can be scattered through the day as necessary though Kumari can get nauseous if she hasn’t eaten in a while.
- Avoid prolonged stressful situations, as much talk of finances/parents as possible as they’re stress triggers, and emotional invalidation when she’s having an episode. (For example, for a common one she often gets the feeling that her boyfriend Chris hates her, rather than just saying “No he doesn’t, that’s silly” give her concrete evidence like “Well, yesterday he sent you that long text saying that he loves you. Why would he have changed his mind?” It’s a fine line to walk, but it helps immensely.)
-In general if something is bothering you make sure to tell her up front, because Kumari is very attuned to when someone is feeling off (a carefully honed defense mechanism) and it helps her immensely to know the actual reason and know that it’s not her. She can always tell when Trevor has a headache and often fears it’s because she did something to wrong him, so it helps to tell her up front “I have a headache!” and problem solved. You may have to tell her a couple times though. ^_^
Our Contact Information
If Kumari needs me (Melinda) at any time, you should be able to contact me by text or call at (my phone). She wants to go home early, get money, pretty much anything, I should be available at any time and will come and get her. My phone is on the older side and getting kind of janky, so if I take a while to respond you can also try my email at (my email) I have gmail chat open every time I’m on the computer, so it’s a viable option. Also for general purpose you can call/text Trevor’s phone at (his phone).
In Case of Emergency
In case of Kumari running away or a medical emergency, send a text and call all of these numbers as soon as possible:
Melinda: (phone)
Trevor: (phone)
Anna: (home and cell phone)
Also if it seems necessary (injury, illness, or disappearance) call the local police or take her to the hospital.
Yessssss.
Anyways, here's our full set of Kumari-Keeping rules, minus contact information! It has a pretty good rundown of a lot of her symptoms, and a few of the ways we try to treat them, or prevent them from manifesting as much as possible. I of course removed the emergency contact info, but otherwise it's unchanged.
Rules of Kumari-Keeping
Important rules to keep in mind while watching Kumari. She can hide it well, but the BPD and comorbid disorder symptoms are very severe, and though they don’t all manifest at once, there can be problems with two or three at a time. In addition to the BPD (which largely makes her highly sensitive to emotional situations or even misunderstandings) Kumari often has actively suicidal tendencies, clinical depression, anorexia (sometimes with bulimic tendencies), binge eating, other self-destructive tendencies (desire to return to alcoholism, engage in unhealthy sexual activities or start smoking), and high levels of anxiety about all of these issues. THESE CAN BE LIFE-THREATENING.
The most important aspect of taking care of Kumari is simple supervision. Keeping a close eye on her means PLEASE SUPERVISE KUMARI AT ALL TIMES! Things to look out for are described below, but actively watching her keeps her mental state better, and makes our job as caretakers much easier. And the likelihood for a major emergency is much lower with some vigilance.
Nighttime is a much more dangerous time for Kumari, because most of her symptoms get worse in the evenings. Make sure Kumari is home by 11:30 to get her meal before bedtime, and if she’s staying with you have her start winding down around then. Meds should be taken as close to midnight as possible once all of her food is eaten and she’s brushed her teeth, so hopefully she can be asleep by 2 (when often things start to get really bad). Be especially vigilant in the late afternoon/evening though.
Prohibited From Kumari
-Sharp Things- This is one of Kumari’s biggest problems right now. Keep her away from sharp things (particularly razors) at any cost. Hide them before she comes over to your house if at all possible. Otherwise, keep track of them and make sure she doesn’t hide any of them on her person. Self-harm is an extremely strong compulsion for her, and she feels much safer in some ways if she knows she has something to hurt herself with, so keep a VERY sharp eye out for anything like:
-Razors (safety or otherwise)
-Scissors or knives
-X-acto or boxcutter blades
-Thumbtacks, pushpins, needles, any other sharp metal objects
-Broken glass- avoid glassware/breakables
-We’ve even had issues with things like fake nails, so err on the side of caution.
Also keep an eye out when in shops or stores for her trying to pocket safety razors, this has occurred before and should be watched for in the future.
-Other Self-Harm- So far this has not been as big an issue as Kumari’s favored cutting habit, but when her other self-harm outlets are blocked and she doesn’t know how to cope Kumari does tend to punch the ground, walls or other things as a form of self-harm.
-Alcohol- Alcohol is a depressant, which is INCREDIBLY dangerous for an already depressed person, especially one on medication for it, to have. Kumari has fun drinking, true, but it will cause problems with her medication and some of her worst points are when depression hits hard.
-Drugs- Well this just goes without saying. No illegal activities, of course, cause paying for fines is expensive, and it’s yet another self-destructive outlet that will just cause problems. Don’t do it.
-Smoking- An old habit of hers, not kept up for very long, but it’s another form of self-destructive behavior that occasionally resurfaces. She told me specifically when she left Cedar Springs to not let her start smoking again. Therefore, don’t let her start smoking again.
-Running Away- Occasionally in high-stress situations Kumari will run away. Literally run in a random direction to try to find someplace to hide, usually to try to cut. DO NOT UNDER ANY CIRCUMSTANCES LEAVE HER OUTSIDE UNSUPERVISED, ESPECIALLY AT NIGHT. If she does this she’s usually found something to hurt herself with, and this could be a potential suicide scenario. This is the worst-case scenario, and if you can’t find Kumari immediately text myself, Trevor and Anna and we can try to contact her- she often tries to call Anna when she’s at her lowest points anyways and will likely answer for her no matter what, and she can tell us what’s going on as well and help locate her. If Kumari has run away and it’s been more than 30 minutes, she’s not answering her phone, and we can’t find her, it’s time to call the police to help look for her. Don’t be afraid to call emergency services in general if the situation calls for it.
-Avoiding Eating/Throwing up- This has been a big issue recently, as anorexia is another form of self-harm that’s very common with BPD. Avoid using guilt tactics when confronting her about eating, because anorexia and associated disorders are a manifestation of control issues,
-Be very firm about how much/when she should eat. (Look up calorie amounts, at least 300 calories a meal, preferably 400). These can come from anything, she just needs that many calories per day.
-Keep a close eye on her bathroom visits until 30min-1hour after she’s last eaten, especially when medication is being taken. Eating causes her a great deal of anxiety and there have been bulimic tendencies recently, and if she actually manages to throw up what she’s eaten recently/her medication she needs to eat again.
-She absolutely has to have at least 300 calories with her evening medicine, the lithium she’s on causes gastrointestinal problems if not eaten with a meal. She waited 3 hours once after having skipped her medication, and it caused her a bad stomachache for several days.
-Actually watch her eat. She should not be able to get away with rearranging her food on her plate or hiding it. Make sure she actually gets an adequate amount of food. Healthy food, if possible, but we’re working on getting her to eat at all right now.
-Skipping medication- Kumari has morning and evening medication. Occasionally she’ll forget her morning medication, which causes a bad bout of depression later in the evening since her morning medication is her antidepressant. This should be taken with food shortly after she gets up. (Once again, at least 300 cal.) The bigger problem has come from her intentionally skipping her evening medication to try to run away later at night. Watch her quite closely around bedtime, especially if she’s shown any warning signs like obviously suicidal thoughts, extreme self-deprecation, or has recently interacted with parents at all. Watch even closer if she very suddenly seems chipper again. Make sure she actually takes her medicine (not pocketed/hidden/flushed down the toilet later) right before going to bed.
Short guide to general care
-Daily caloric intake is 1500 calories for weight-loss. Any less is detrimental. Make sure at least 300 are eaten with breakfast and medtime, the others can be scattered through the day as necessary though Kumari can get nauseous if she hasn’t eaten in a while.
- Avoid prolonged stressful situations, as much talk of finances/parents as possible as they’re stress triggers, and emotional invalidation when she’s having an episode. (For example, for a common one she often gets the feeling that her boyfriend Chris hates her, rather than just saying “No he doesn’t, that’s silly” give her concrete evidence like “Well, yesterday he sent you that long text saying that he loves you. Why would he have changed his mind?” It’s a fine line to walk, but it helps immensely.)
-In general if something is bothering you make sure to tell her up front, because Kumari is very attuned to when someone is feeling off (a carefully honed defense mechanism) and it helps her immensely to know the actual reason and know that it’s not her. She can always tell when Trevor has a headache and often fears it’s because she did something to wrong him, so it helps to tell her up front “I have a headache!” and problem solved. You may have to tell her a couple times though. ^_^
Our Contact Information
If Kumari needs me (Melinda) at any time, you should be able to contact me by text or call at (my phone). She wants to go home early, get money, pretty much anything, I should be available at any time and will come and get her. My phone is on the older side and getting kind of janky, so if I take a while to respond you can also try my email at (my email) I have gmail chat open every time I’m on the computer, so it’s a viable option. Also for general purpose you can call/text Trevor’s phone at (his phone).
In Case of Emergency
In case of Kumari running away or a medical emergency, send a text and call all of these numbers as soon as possible:
Melinda: (phone)
Trevor: (phone)
Anna: (home and cell phone)
Also if it seems necessary (injury, illness, or disappearance) call the local police or take her to the hospital.
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