Long overdue post…

I thought it was time to explain where I’ve been, but I am not planning on staying long. Just a quick hello and goodbye for now. I feel bad it’s taken me so long, but I wasn’t sure what to say and kept putting it off.

I guess I have just been busy in the real world. That and the fact I had therapy. It seems that having a one hour session a week to contain any mentalism and to whine and moan, meant that I didn’t feel the need to come here. I have just 2 sessions of therapy left now, so by the end of August that may change. Maybe I will come back sometime, but I don’t know. My therapist was never keen on me blogging whilst I was seeing her and although I wanted to continue, in part to rebel against her disapproval, it just didn’t happen. I seemingly ran out of things to say.

I’m not sure how useful therapy has been. We have hardly looked very deep or at anything especially long-term. The therapy itself was neither very long term nor intense, but that didn’t surprise me. It might have been what I supposedly needed, but the NHS was unlikely to ever provide it. I will have had a total of 20 sessions, spread over 8 and a bit months. It would have ended a lot sooner had my sessions not been on a Monday, meaning plenty of missed weeks for bank holidays, my holidays, her holidays, sickness, her training etc. She’s away again next week. I can’t wait for the sessions to end and to get my Mondays back.

So aside from therapy I’ve been busy in the real world. My mood was really quite crappy in Feb and it got to the point where I gave in and started Mirtazapine on top of my other meds in the hope it would lift my mood and help me sleep. I wasn’t keen on the idea, but it seemed to help with the mood at least. It knocked me out for all of 2 days before the insomnia returned. Coupled with the arrival of spring, my mood recovered sufficiently that I stayed in work throughout the mini-episode, albeit on just a few hours a week.

Since then my mood has continued to improve and I’m now relatively “well”. My hours at work have been increased steadily and I’m now working part time, roughly 22hrs a week on some vaguely proper work rather than mundane tasks. I’m still internally based, but the work I’ve been doing has been pretty interesting and I’ve even had colleagues to work with, although we were at different ends of the country most of the time. I did get to spend a couple of weeks in London with them though delivering some training, which was awesome and I’m down again for a few days this week. I’m back to more mundane stuff again over the next few weeks though, but generally my employer have been good at finding me things to do and helping me to get back. I genuinely love my employer and my current HR team. They have been pretty instrumental in keeping my mood afloat and life feels hopeful. Dr N (GP incase you’ve forgotten in the last 6 months) said to me the other week he’s amazed at how well things are going and I’m inclined to agree.

The only remaining issue really is my sleep. It is still poor at best. When I have been working away it has been worse than poor. There have been nights where the whole experience has been painful and fear-inducing and I just wish night never happened and that my body didn’t need sleep at all. I take forever to get to sleep, when I do get to sleep I am drifting in and out of consciousness and dream worlds. I have frequent nightmares and strange dreams. Sometimes I am unsure where reality meets my dreams and everything becomes very strange and scary. I wake up and fall asleep dreaming and wake up and fall asleep and dream and wake up etc on a roughly 10 minute cycle for a few hours and then I can’t get back to sleep again and then often it’s time to get up. Or I am just awake for hours and it is only 6am or something when I fall asleep and then I should be getting up and can’t drag myself out of bed. There seems to be little to no sign of improvement, even after reducing the reboxetine in June. I explained how desperate it was making me to Dr N and he gave me an emergency supply of Temazepam in the hope that if I had a back up plan it might help reduce my anxiety about sleep. I’ve taken it on one occasion and it didn’t seem to help, but I’m too scared to take it on a night when I need to be awake the next day incase for some strange reason it decides it might work for once and I can’t get up! Benzos have never been much help though, but at least they don’t seem to make the whole dream/hallucination thing worse like the Z drugs do. Sleepers just don’t work. No chance of me ever getting addicted.

I’m still sleeping badly and basically just putting off the time when I should try and go to sleep this evening by writing here. I’m in a hotel again, which makes it worse. At home I’m made to go to bed at the time when my bloke dictates he wants to go to bed and I am forced to stay there so I don’t want to wake him or the dog up too much.. If I wake up from a nightmare or anything he helps to bring me back to reality quicker and his presence calms me down. Usually his snores are a reminder that everything is fine and normal and the wardrobe isn’t full of strange men trying to chase me (or whatever else decides to infiltrate my dreams and reality that night). Here in a strange hotel room the boundaries between reality and nightmareworld are a lot more blurred because there is no one to calm me down and I can never quite remember where I am. Monday night was bad. Just wide awake all night. No sign of sleep and increasing frustration at the lack of sign of sleep, which never helps. Yesterday was better, but still not great. I had a lot of dream stuff going on and the every 10 minute waking thing, but at least I got some sleep. I’m meant to be trying to keep a sleep and dream diary for the next fortnight for the therapist, but the problem is I often wake up panicked and even screaming, having no idea what it was that was making me scared. I rarely remember much content. I’ve been trying to keep the notebook by the bed and jotting things down, but that wakes me up even more and just prolongs the wakeful periods between the dreamfilled ones. The problem is though none of that sleep is quality. It isn’t restful and doesn’t recharge the batteries. Eventually I have to get the sleep somehow. During the first weekend of the last 2 week stint in London (a month ago) I just crashed and slept a lot (at least by my standards! I was in bed a lot). The second week was not so bad. The first week at home was better and last week less so. This week has been worse again. I could do with crashing and catching up again, but that is unlikely to be an option any time soon with a wedding to attend on the weekend.

If I could just get the sleep issue fixed I really could be convinced that life is getting back to normal and all will be well and good. Life is getting there. This may be “recovery”, but this is definitely holding me back. It still makes the prospect of full-time work scary and possibly impossible. My shortened days at the moment make the sleep issue less of a problem – I start work late and that seems to help.

Anyway, I should stop writing. I was only meant to be here to say bye and sorry for not saying it sooner. I seem to have written a massive post. Maybe I haven’t lost the ability to blog after all. I don’t think that means I’ll be back though.

I haven’t read many blogs of late either. I am very much out of the loop in terms of the madosphere and haven’t even read any TWIM since it moved. In fact I went weeks without looking at a single blog post, but I’ve read the odd one since, just to check you’re all still there. There are a few of you I miss a lot. Some I am in touch with in the real world. Some whom I’m not. If I’ve stopped reading, it doesn’t mean I’m not thinking of you. I do appreciate everyone who has been reading and around for me when I needed it and everyone that ever commented here. I feel a bit guilty for not being around for you, now that I don’t need it so much. Sorry.

I shall sign off. I may be back one day. I may be back another day. I may never be back. I don’t know.

Take care xx

Home Alone…

Time keeps passing. I don’t know where it goes to.

This weekend has been somewhat strange. The bloke is away for the weekend at a stag do and I’m home with just the doggy for company. I don’t remember the last time I was here on my own overnight, let alone for a whole weekend, so I don’t really know what to do with myself. Aside from my trip in the summer, there have been so few times when I’ve been without the bloke for more than a day since we went to uni. I was “well” in the summer too and now things are not so easy. I am managing, but it has made me realise how used I am to having him around and how much his presence keeps me functioning. Without him here, the temptation to give in and give up is so much greater.

Getting up and dressed is a struggle at the moment and I feel even less urge to conform when I don’t have reminders from the bloke. The guilt wears on me when he’s about and it serves to push me into action. It was only the desperate requests from the dog to be let out, that dragged me out of bed this morning. The thought of having to clean up any mess was enough to force me downstairs, but I climbed back in when she was sorted. I had to get up in the end as I was going over to a new friend’s for her kiddy’s 1st birthday party, but it took me literally hours to work myself up to that. Without that commitment today, the temptation would have been to stay in bed all weekend.

Food is another problem. The bloke is the cook in our house. I can bake cakes, but when it comes to a proper meal I don’t tend to bother. I don’t have the best appetite these days, but when food is presented to me I do tend to eat. Without the bloke around to cook for me, I don’t tend to bother. I’m even less inclined to cook at the moment as both our oven and the microwave are broken.

The dog is a commitment too and she does keep me going, but she isn’t as effective at nagging as the bloke is and I find the commitment straining. She did get me up this morning and she gets me into the kitchen, prompting me to eat at the same time that I feed her, but she is also tiring and I feel guilty when I just want to stay in bed and ignore her. She also got me to go outside for a walk, which I know is good for me, but at the same time I wish I didn’t have to. It’s so tempting not to bother, but I cannot deny her a walk for long or she turns into a great big bonkers thing, which is even more draining to live with than the walk.

I’m really tired. I want to sleep forever, yet sleeping for just a few hours seems to be enough of a challenge. It was late when I finally dragged myself upstairs to bed last night and I sat and knitted up there for a while because I couldn’t sleep.

Before the bloke left, I had to promise I’d be safe this weekend. He has been somewhat paranoid over the past few weeks that I’m suicidal again. The last two years have been particularly difficult at this time, in the run up to my birthday, so I know he is on edge. He doesn’t trust me at all and although I know his fears are not unfounded and it is only because he cares, it is still hard. One day last week I had nipped out and wasn’t home when he was due back from work. My mobile phone battery had died so he couldn’t get hold of me. I’d even left a note to say that I’d be back in a minute, because I worried that without my phone he would wonder where the hell I was, but he didn’t see it and just flew into a tailspin instead. He completely jumped to conclusions and panicked that I’d gone out to kill myself.

I’d actually nipped out to rescue the dog’s ball because she had lost it on our walk and I couldn’t get it out of the brambles and control her at the same time. She has a habit of diving head first into all the brambles and rose briers to rescue her ball then getting stuck – we both end up cut and bleeding, as I have to battle to rescue both her and the ball. I literally had to drag her home, shut her in the house and then go back out to dig out the ball from the bushes. By the time I got home I was greeted by the bloke just about to drive off in my car to try and find me, ranting and raving with anger. This isn’t the first time this has happened, but it the first time in a long while and I was disappointed that things had not moved on and that the trust hasn’t been rebuilt by now.

It turns out that he mainly panicked because he had been reading my mood log. I was updating one online and I had no idea he had been reading it. I tended to keep my notes in there very short and they were only for me, so a note mentioning suicidal planning thoughts did not necessarily mean what he thought it did. I was angry that he had invaded my privacy again, but I know it only comes from fear and concern. I don’t feel able to update the log any more though. It was meant to be for me and no one else. A reminder of how things are, because so often I cannot remember what my mood was like a week or a month ago.

But anyway. I agreed that I will be safe. I am safe, but it doesn’t mean the temptation isn’t there. My mood is low and I’d be lying if I said I didn’t think about it. This weekend would have been the perfect opportunity and there are times when I cannot help the thoughts, but I have resigned myself to sticking around for a while yet.

I know the fact it is winter and in the run up to my birthday can’t be helping. I have been in hospital at this time for the last two years, and both times I was desperately suicidal and determined not to be around for my birthday. This year I seem to have accepted that I will be around and although I am not overly happy about it, I’m resigned to it. I am low and I don’t really want to be alive, but I feel the obligation to be. Also, I’m not sure why, but being 25 seems like a much better idea than 24 anyway – something about round numbers I think. My worry is that I’m already having to battle the thoughts that 25 is a good age to die. I have no desire to see 26, even if I am sure I will see 25. I hope that my mood will pick up before those thoughts get too strong or that the approach of my 26th birthday gets too urgent.

As for my 25th birthday, as Seaneen will recall, my invite for a smear test arrived. I went and had it a couple weeks ago and it was fairly painless and straightforward, although I bled quite a bit afterwards. Unfortunately though I got a letter on Thursday saying the result was “inconclusive” so I have to go and have another one in three months. I think this was just a case of not enough cells, at least that’s what I’m hoping, but it’s still pretty annoying to have to wait before they do it again.

In other news, I’ve had a review form for DLA to fill in for a couple of weeks now and I’ve failed to do it. I wrote to them before Christmas at the same time I wrote to notify the DWP that I was starting work part-time for ESA purposes, to say there had been *some* improvement to my condition since my initial application for DLA. I felt I had to, as I have been receiving Higher Rate Care and I am not sure I should be getting that rate any more. They sent me out a review form and I started to complete it, but I made a complete mess. I filled in my surname in the first name section, my date of birth wrong and made mistakes all over the place, because I couldn’t concentrate enough to fill it in and my memory is so shoddy I kept forgetting things. After some frustration, I rang them to ask for another form because I had made so many mistakes. I got this replacement two weeks ago now and I have still not even started it. Thankfully because I requested the review rather than them, there is no deadline for me to get it back, but I know I need to do it. I can’t face it though. I can copy across the stuff that was correct on my first attempt, but I don’t know what to do about the rest of it. The form is overwhelming and I don’t know what to write, especially as my mood has been so unstable of late. Sometimes I look at the form, think nothing is wrong and answer everything as if I was fine, but other days I look at the form and realise I can’t do any of the things it asks, including filling in the form for that matter. I know you have to say how your good and bad days very and highlight what the worst case scenario is, but I just don’t know what to write. I don’t even know what to put in the diagnosis section. Should I have told them that my diagnosis is under question back when it was first questioned a year ago, or can I just tell them I don’t know any more? I guess the latter is the truth, I don’t know, but I’m not sure if I should have told them I don’t know. As far as DLA and ESA are concerned, I assume they think my diagnosis to be Bipolar II disorder, which is what it was when I applied. As I don’t know what it has been changed to, I guess I can’t tell them, but I worry about what Dr M or Dr N will write when asked. I hate having to evaluate how bad I am. I honestly don’t know.

Hmm I don’t know what else to write. There are things I keep thinking about to write, but I just don’t know what to say. It has been the same all week. For weeks really. I am meant to be keeping a diary for therapy again and I haven’t managed to write anything properly. I just don’t know what to say. Brain is mush. I cannot think, I can barely feel. I just want a new head.

I am feeling increasingly agitated this evening. I am not sure why. Maybe now is the time I stop and knit for a bit to see if it calms me down. I spent a lot of yesterday knitting – I made a hat for the little boy’s birthday today and started a frilly scarf and it kept me busy and distracted whilst I was on my own. It’s the first thing I’ve done for a while. I haven’t had the motivation or the concentration for a while. Sometimes I get the urge to knit and think of a million projects I could be doing and other days I cannot even comprehend lifting the needles. There has been a lot of the latter lately, yet yesterday my head was buzzing with ideas of things I could knit. I can only knit so much though and when my concentration is so crap lately as much as I want to make these magical creations, there’s no way I’m actually able to. I end up having to undo as much as I do.

hmm. Head is starting to spin. I’m both tired and agitated and feel like I may need to throw things soon if things get any worse. I don’t know why I am feeling like this. I have been good lately and I’m avoiding caffeine in the hope that would ease the occasional agitation, but it doesn’t seem to be helping. Maybe I should just go to bed and try to sleep or maybe I should have a bath. Perhaps I’m just grouchy and tired. I don’t know.

This is a bitty post. I don’t seem able to write properly at the moment. I started writing this about 4pm and it’s now 11.30pm. It’s not even very long. I have found it really hard to try and get things down or to concentrate on it. I have watched bits of TV and fed the animals and stuff in between, but the rest of the time I have just been staring at the box wondering what to put in it, or more likely how to slow down and speed up and unravel my thoughts to try and type them. Some of the time it feels like my brain is like treacle and the thoughts are just so slow and other times they are bouncing around and rattling off the sides and at the moment both is happening at the same time and it just feels like a big ball of mush. It all makes no sense.

Anyway I am going to stop and kick the dog outside. She’s already taken herself to bed, but she needs to go out or I’ll get woken up very early in the morning! I don’t intend on being up early. The bloke isn’t due back until at least mid-afternoon and I think I’m leaning towards a morning of hibernation.

Too much to say…

I have lots on my mind and plenty that I’d like to share, but the time and motivation has been lacking. I wish I could just empty my head onto this blog, without having to go to the effort to sit here and type. When I am lying awake at night, I think about what I’d like to post, but I rarely make those posts a reality. It would be brilliant if I could make posts happen just by thinking of them. It would make me a much better blogger and would save me a lot of time. It would give me something to do when I can’t sleep. It would also mean that this post wouldn’t have taken over two weeks to materialise.

So the big news is I’ve started therapy. Or rather I’ve started the assessment sessions for therapy with the new psychologist.

The first few appointments have been okay I guess. During the first appointment we mainly talked about the practicalities of therapy and she updated me on the changes going on in the service (change in Trusts). She asked me a bit about what has been going on for me lately and how I feel therapy can help. I didn’t really know what to say, but found myself talking about the whole diagnonsense malarky. I was scared about getting onto such territory, but I guess the fact I felt able to bring it up must suggest I was relatively comfortable talking to her. I was worried about how she would react but she seemed reasonably sympathetic and supportive of my concerns. I told her I was unhappy about how they were so quick to change my diagnosis to a PD, especially when I was obviously unwell and not exactly demonstrating my usual behaviour. I think she understood, but I don’t know if she agreed as such.

I felt completely exhausted after the first appointment. I had to go straight to work and had a few errands to run and wasn’t in any frame of mind to do so. I was feeling really dazed and found it was impossible to concentrate. I didn’t get anything useful done at work, but at least I didn’t have anything important to do. I got lost twice that afternoon too. Despite looking up directions, I would forget where I was going before I got to the first junction and have to pull over and look them up again. In total, I probably spent over an hour driving in circles on that day trying to find the depot to collect a parcel. One of the places I’d been to hundreds of times before too, which is even more frustrating because I never used to get lost. If I’d been somewhere, I could always find my way back. Not any more.

The second appointment was a lot less structured than the first and felt like it went all over the place. We covered ten billion things, yet I don’t know how much was relevant. It felt like we were skipping over things too quickly and completely missing out others. I guess it is hard to know where to start when there is so much history to cover and so many different layers. The appointment went in no time and I can barely remember anything which was discussed. At the end she suggested we tried to start from the beginning for the third appointment and she asked me to put together a timeline of key events, separated by good times and bad times. I’d done timelines and histories before, but was a bit worried about putting it together again and leaving things out.

So the third appointment was meant to go over my time line, but we ended up talking a little about the second appointment first. When we did get on to the timeline we didn’t get very far. We only managed to cover up until the end of primary school really. She asked a lot of questions, mainly about my family and what life was like as a child. I can barely remember, so this was hard and I didn’t know what to say. I have a few clear memories and a lot of fuzziness. The session disappeared in no time. We’re meant to be picking up on it again next week. Fingers crossed we will cover a little more. There are only two more assessment sessions left.

Aside from therapy I have got very little else done over the past few weeks.

I saw Dr N a couple weeks ago and we discussed the medication question. He hadn’t got the letter from Dr M. He said it usually takes her a while. I explained what her suggestions were and we discussed it. He thinks Quetiapine should be a definite no, which I agree with. He didn’t think it helped me the first time around and as I’m already on the Lamotrigine as a mood stabiliser he is not sure it will help. He was really keen for me to come off the Reboxetine though and was keen to find an alternative. He said that I have been “really quite unwell” since I started it. I know I’ve been struggling a lot with the side effects, but I’d never really considered the physical illness to be all that important even though it is problematic. I have always thought the mental improvement was worth it. When I was so depressed before, it was just a relief to feel different. He is not so sure that Reboxetine is good for me though. He still isn’t even convinced the Reboxetine was responsible for my mental improvement. I don’t know. He seems to like the idea of trying Mirtazapine. He considers it a more effective anti-depressant and thinks it will help with my sleep. We talked about the weight gain and he said I could always stop it if that became a problem. Overall, he seemed to want me to take it and he offered to write me the script, but I wasn’t so sure. I mentioned that the bloke wasn’t keen on the idea and he said that didn’t surprise him. It’s so common for people to want you to take less pills, not more. To be fair, I’d like to take less pills, but I know that is probably not a wise option. I decided I’d like to wait and think about it a while longer though. I also mentioned that I’d got the therapy appointment through and he agreed that therapy may be a reason to hold off making any changes right now. I wouldn’t be able to tell if something was making me worse or know what to blame. So that’s how I left things. I am going to see how the first few therapy appointments go and then decide. I could try and hang on until Spring and then maybe I can manage with a lower dose of Reboxetine again anyway, but we don’t know. It’s another case of “we shall see”. It’s a phrase I seem to use often at the moment.

I had my dental hospital appointment as well a few weeks ago. That was to discuss the TMJ (jaw joint) problems I’ve been having. I had an x-ray and after a long wait the consultant poked and prodded and moved my mouth about, to come to the conclusion it’s a cartilage problem. She didn’t really offer any solutions to this problem, other than the usual stuff. I was aware of the normal management techniques already – identify habits such as nail biting, night-time grinding etc, do some simple jaw exercises and take ibuprofen regularly. She agreed that there was no evidence of night-time grinding from my teeth, so she doesn’t think a splint or mouth guard will help. She did notice that I had short, bitten nails, but I actually tend to pick at them with my fingers rather than bite them. So she’s given me some jaw exercises anyway and I see her again in 3 months.

There was one weird thing about the appointment though. The consultant reminded me an awful lot of Dr Shock, who was in charge of the ECT. Considering I attribute the jaw problems to the ECT, I found this very unsettling. I don’t really remember what Dr Shock looked like, but this consultant was an equally large woman and I remember her voice was very similar. Something about her manner reminded me of her too.

Thinking of ECT, I drove past the hospital today. I have been past a couple of times since I had the treatment and every time I go past I feel a bit weird. I think of the taxi trips over to the other hospital and the strange nervousness that went with it.

Last week I had another appointment with Dr Occy Health. It was a strange appointment, made stranger by the fact he misunderstood me near the beginning and it only become clear towards the end of the appointment that he was mistaken. When I said I was still only working 6 hours a week, split over 2 days, he thought I was working 6 hour days, twice a week (12 hours). This is understandable because it is what we were aiming for. He went through most of the appointment under the assumption I was fine, had met the 12 hour target and we should set a new target of 15 hours by the end of Feb. I didn’t realise until he went to dictate his letter at the end. We had to back track quickly and he said we should just stick to the 12 hour target for now then. He was keen to stress that managing the 6 hours was an achievement, but I felt like I’d let him down a little. He seemed so pleased at my supposed progress, it was a little disheartening to admit I’d not made the target. Admittedly part of the reason for not making that target has been the reluctance to increase the hours from HR. Rehab Consultant Woman happened to contact me when I was at my worst in December and she had been somewhat concerned that I was struggling. It seems she passed this message on to HR, which is why they wouldn’t increase my hours. I hadn’t realised this at the time. Despite the fact I have been struggling a little, I’m not sure extra hours will make it worse. If anything it may even help. I often feel that the 3 hours I am working is not long enough and I try to cram too much stuff into that short period of time. A little bit more time may help me slow down. I don’t know. Then again, I don’t have enough work to fill 3 hours, so how I expect to fill 6 I don’t know.

Anyway, I should sign off. My mood is still up and down and all over the place. I’m managing though for now. Not getting much done aside from work, doctors/therapy appointments and walking the dog, but I am treading water I guess. It is a struggle, but I just have to keep reminding myself I’m miles ahead of where I was this time last year.

I hope everyone else is coping okay. Sorry I’ve been rubbish at commenting and stuff lately. I’m trying to read what I can, but I am also trying to step away at the same time. I find myself losing time and unfortunately reading blogs seems to eat time pretty quickly, so I am holding back until I can find the time.

A little unstable…

I have been quiet over the past month or so. I keep thinking “oh, I really must get around to writing that post”, but it never seems to happen. I do start posts, but somehow they never get finished and by the time I get around to it they have become irrelevant and I end up having to start again. I guess if I started writing shorter posts, it might not take me so long to finish them!

My last proper post (excluding the 2010 review) was pretty negative, but an accurate reflection of my mood at the time. Things have improved a since then, although they still feel a bit shaky. I felt really really awful for a few weeks, but Christmas was bearable and I was able to keep going without slipping any further, so that is encouraging. If that is as low as I get, I can survive, but I don’t know how much lower I could go without ending up back where I was a year or more ago. There were definitely times when I didn’t think I’d make it to here, which was worrying – I’ve not felt like that for a while now, but it has passed now really.

Over the past week I have felt a little on the edge. Motivation has been somewhat lacking and I feel exhausted and low, yet there has been a strange bouncier edge to it too at times. Things don’t feel stable any more. 2010 was a year of relative stability. During summer things were pretty consistent and I felt quite well. Since autumn I’ve been consistently low, but mild depression is manageable. Now I’m all over the place. A few days feeling better, a few days feeling rubbish, one day where I feel all over the place, another where I feel strangely mixed, the occasional day when I just feel normal. There is no consistency at all anymore.

My sleep in particular is a mess. I really struggle to get up each morning and feel exhausted, but then I spend the late evenings trying to slow down my racing and flighty thoughts. I can’t seem to concentrate on any one topic but spend the night with random things darting around my mind. Even when I do sleep, my dreams jump about and I wake up frequently, often shaking or panicky. My dreams have been so weird it has been disturbing me. I find myself thinking about them in the day or unable to shake the uneasy feeling that goes with the nastier ones. Occasionally suicidal thoughts pop up and sometimes these thoughts can be so clear and urgent it can be scary, but there are also excitable flighty thoughts – plans about holidays, knitting, work etc, which would suggest a good mood. It feels slightly strange and can be somewhat frustrating when I can’t sleep, but it is preferable to feeling how I did before Christmas. I quite like the flighty-awake feeling and if I didn’t need the sleep I’d happily become nocturnal and make the most of it, but my body is really tired and I don’t want to keep the bloke and the dog up, so instead I lie in bed tossing and turning.

The last couple of days haven’t been so bad on the mood, but I have been struggling with nausea on and off. I’ve not been sick, but on Sunday night I felt awful. Being sick would have probably been a relief. Nausea does tend to calm down the flighty side of things as moving about just makes me feel worse. Not feeling too bad at the moment, but it seems to come and go.

I am hoping the recent instability can be put down to fiddling with the Reboxetine dose and not taking it consistently at the same time, but I’m not so sure. Things were going haywire before I started the dose experiment. I was told to try taking 8mg some days and 6mg on others to see if it helped with the side effects. I tried it for a bit over Christmas but I found it made the side effects worse than normal on the day I took 8mg and I didn’t feel much respite when taking the lower dose. I’ve also been struggling to get up, so was taking it later than normal, which definitely contributes to the insomnia at the other end of the day. I was trying to take a lower dose on those days, but that didn’t seem to help too much. Things are noticeably worse though if I take the full 8mg dose after about 11am. I’ve gone back to the full dose though and am taking it earlier again, so I hope that will help settle things down.

I saw Dr M on Friday. I mentioned all of this to her. The rapid decline in December, the slight improvement over Christmas and the up-and-downy-ness since. She seemed slightly surprised and a little concerned when I indicated how bad I felt in December, but relieved things have improved a bit since. She thinks I’m a lot stronger these days and that I will be able to manage things better even if I do get more depressed. I think she is probably right.

We discussed medication again. She does think something needs to be added to the Reboxetine. If we can boost the effectiveness of the Reboxetine then maybe I could drop the dose and reduce the impact of the side effects. She’s concerned about sleep too and wants something that will help on that front at the same time. Quetiapine was encouraged again, but I’m still not keen on the idea. It didn’t do anything helpful for me before and I doubt it will again now.

The other option was Mirtazapine. I’m not sure about this either, mainly because of the weight gain risk. I’ve lost a lot of weight over the past year and the last thing I want is to put all of that back on. Aside from that it could probably be a good option. It is meant to be sedating and also partly works on Noradrenaline, which should help. It has a longer half-life than Reboxetine, which could also help stabilise things.  I haven’t tried it before so it may be worth a try, especially as it can work when other drugs haven’t, but I’m not sure. I don’t know if it is worth the risk of it not working, although I guess if the side effects are bad I can always discontinue it. I think I’d also be slightly annoyed if it did work because Dr N and I considered it right at the start, but decided against it because of the weight gain risk. Imagine if it is the right drug and we’d chosen it right back then – maybe none of the past 2 years would have happened. Glorious hindsight. I am not sure though and the bloke is definitely not keen on the idea. He thinks I should just try and manage as I am and do what I can to boost the Reboxetine over the winter. Maybe he is right, but then again I don’t want to experience a sudden drop again like in December as if that happens maybe I won’t be able to manage.

I didn’t want to rush into any sudden decision with Dr M anyway, so she said she’d write to Dr N, tell him what she suggests and leave it up to us to make the decision. He can prescribe it if I decide to give it a try. I need to book an appointment to see him and see what he thinks. I think he would be pretty keen to get me off the Reboxetine if we found an alternative that didn’t send me mad, but it’s a risk and I don’t know if it may be better to wait and see.

Friday was also a year since I tried to freeze myself to death whilst overdosing (it sounds ludicrous to me now) landing myself in hospital for 5 weeks. It was weird to see Dr M almost a year on from when we first met and I mentioned this to her. We both commented on how much better things are now. Quite a lot has changed since then and I do wonder if her initial impression of me has changed. I realise now that I was delusional and paranoid at the time we met, as well as being suicidally depressed, but it still upsets me that my behaviour was put down to a disordered personality and not simply the fact I was somewhat mood-disordered and dealing with the after effects of an overdose. I was definitely not myself and I don’t know how anyone could take that first meeting as representative of my usual personality. I am still frustrated by the whole thing and find myself pondering over it again and again. I wonder if now is the time to challenge the whole diagnosis malarkey and find out what she thinks now she has had much longer to get to know me. I wanted to bring it up and I keep considering it, but I’m just too scared. I am terrified of being told they still feel I have a PD. At least before there was always that bit of doubt and a hope they would realise they were wrong. If I bring it up then I may have to face the fact that diagnosis is going to follow me around.

I’m not sure if I ever wrote about this before, but one of the main reasons I want to challenge the diagnosis again has come from the appointment I had with the locum GP a few months ago. When I was there, he looked back through my notes to find something. We were both watching the screen and as he scrolled through I could see that “Personality Disorder – NOS” was filled in the diagnosis box, visible in big bold letters. On some of the entries it didn’t even list “Recurrent Depressive Disorder”, which is meant to be my main diagnosis. In fact it is meant to be my only diagnosis, because I had been told that they wouldn’t give a proper diagnosis of a Personality Disorder unless the psychologist from psychotherapy (when I eventually start it) thinks I warrant it. I had assumed all mention of the dreaded diagnosis would be dropped until then. Apparently not.

So yes, this has concerned me and since then I have toyed with the idea of applying for my notes. I want to see what has been written about me, especially about diagnosis. I have been somewhat paranoid since. I worry about being seen as just another PD and that any physical problems are seen in this light. I worry that Dr N thinks I’m making things up. It has definitely damaged my relationship with Dr N, as I worry that he just sees me through PD disordered lenses and I don’t feel I can trust him as much anymore since finding out he has been using the PD as my diagnosis. I have found it a lot harder to talk to him since then. I have thought about bringing it up since that appointment, but the time passed and I think I missed my chance.

Another opportunity to bring it up may come up soon though. On Saturday I finally got my new assessment appointment date for psychotherapy. It has been nearly 18 months since I was referred. I have an assessment tomorrow with a clinical psychologist, HP. I hope it is less pointless than the last one, but I have no idea what I can say to her. I am worried about bringing up the diagnosis thing. I may just see if it happens. I don’t know what we are going to talk about though. I have no idea what may help or what I need to discuss. In general things are okay and the things that were identified long ago are no longer relevant. It is the more physical sides of depression that get me most these days. I’ve waited so long that I have to see what they can offer though. Maybe it will help in the long term. It may at least help to have somewhere to discuss how I’m feeling about work as I’m trying to get back. I’ve felt a bit on my own in that regard. Fingers crossed it goes okay anyway.

The other thing that Dr M brought up at the end of our appointment, was this blog. She asked if I was still writing. I admitted that I was, although a lot less often than I used to. I said that I keep wanting to write, but don’t often find the time. I go through fits and starts. She seemed to find my response interesting and seemed intrigued. I wondered if she would get curious and want to look at the blog since. I suspect she may have, as someone in the area visited the blog the day after my appointment. I don’t know whereabouts she lives in the area and I guess it could be anyone, but somehow I got a feeling it was her. I’d like to know if she has read it or not though.

So yeah, that was that. I have a lot half-written about work and more to say, but I will leave that for another post. No idea when I will write it though.

Reviewing 2010…

So everyone seems to be doing the New Years meme. I used to do this years ago back in the days when I wrote on Livejournal and I’ve copied the questions directly from the last time I did it on there (2007), so if it is different to the version everyone else in the madosphere has done, then that will be why. It is a bit weird to see these questions again.

1. What did you do in 2010 that you’d never done before?:

Take Reboxetine, Go InterRailing, Learn to Knit.

2. Did you keep your New Year’s resolutions, and will you make more for next year?:

I don’t usually make any and I can’t remember if I did last year. It seems unlikely because I was planning to kill myself on 7th January and any more resolutions would have been pointless. I tried and failed at that one.

This year, I haven’t set any firm resolutions, but most of my hopes evolve around recovery. I hope to get back to work full time and stay out of hospital.

3. Did anyone close to you give birth?:

Not that I’m aware of!

4. Did anyone close to you die?:

Thankfully not.

5. What countries did you visit?:

Oo. I went InterRailing so I have visited a few this year! I passed through France and visited Belgium, Germany, Poland and Austria.

6. What would you like to have in 2011 that you lacked in 2010?:

Proper recovery – I started to recover in 2010, but there’s still a long way to go. I want my life back.

I also want to move house, so a new home is pretty high on my list.

7. What dates from 2010 will remain etched upon your memory, and why?:

I don’t tend to remember dates very well and the only date that really comes to mind is the 7th Jan for the reason mentioned in answer to question 2.

I think the 29th July was the day that I set off for Europe, so that’s a good one too.

The week beginning the 15th November also sticks in my mind, as it was the week I started my phased return to work.

8. What was your biggest achievement of the year?:

Travelling around Europe for a couple of weeks on my own and getting back to work, albeit for only a few hours a week.

9. What was your biggest failure?:

I’m not sure it is a good thing that the first thing that comes to mind is my failed suicide attempt. Definitely a failure, but whether that is a good or a bad thing is up to debate depending on my mood.

10. Did you suffer illness or injury?:

Mental illness never really goes away. I also battled with side-effects and tummy troubles a lot. My jaw has continued to be a problem too – I have a visit to the Dental Hospital on Monday to see the Temporomandibular Joint specialist. I had a common cold over New Years at both the start of 2010 and 2011 too.

11. What was the best thing you bought?:

Either my InterRail pass or Glastonbury Tickets. My prescription pre-payment certificate should probably be considered too.

12. Whose behaviour merited celebration?:

Nikki dog’s behaviour merits celebration and reprehension on a daily basis!

13. Whose behaviour made you appalled and depressed?:

Occasionally The Bloke’s, but like Nikki, he can merit celebration too.

Dr M made me pretty appalled at the start of the year, but I don’t mind her so much these days. I may even confess to liking her!

14. Where did most of your money go?:

The usual – rent, food etc. The dog spends a lot of it too!

15. What did you get really, really, really excited about?:

I don’t tend to get really excited about anything when I’m feeling low. I was quite excited about the InterRail trip, although it was such a spur-of-the-moment thing that I didn’t have much time to get excited about it beforehand. I was quite excited about Glastonbury this year too – I actually felt able to enjoy it!

16. What songs will always remind you of 2010?:

Regina Spektor – Laughing With
Lady Gaga – Just Dance – especially reminds me of watching Dancing on Ice in hospital last January.
Laura Marling – Goodbye England (covered in snow)
The XX – Intro – reminds me of the General Election coverage on the BBC mainly, but also of the start of their set at Glasto.
Marina & The Diamonds – Obsessions – and pretty much the whole album really. She was great live too.
KT Tunstall – Weirdo – and again the whole album and seeing her live.
Miike Snow – Animal – reminds me of InterRailing. They played it a lot in the hostel in Krakow.
Ellie Goulding – Your Song – and again pretty much her whole album.

It has been a good year for music. I’ve certainly listened to a lot more this year.

17. Compared to this time last year, are you:

i) …happier or sadder?: I’m a million times happier than this time last year. I was on a psych ward having just failed to kill myself, so not exactly at my happiest! Compared to 6 months ago though I’d be sadder.
ii) thinner or fatter?: A lot thinner. I’ve lost over 3 stone since I came out of hospital last February.
iii) richer or poorer?: About the same I think.

18. What do you wish you’d done more of?:

Working, writing, knitting, swimming, seeing friends… Lots of things really.

19. What do you wish you’d done less of?:

Feeling sick, lying in bed with no motivation, seeing doctors and generally everything related to being ill. Arguing with the bloke comes a close second.

20. How will/did you spend Christmas?:

We spent it in Wolverhampton with the Bloke’s mum and sister. His aunt, uncle and cousin also came over for Christmas dinner. I saw my parents on 27th Dec and a load of friends came around for a big Christmas Dinner on 28th.

21. Has there ever been a question 21?!?

22. Did you fall in love in 2010?:

Nope. Not with anyone or anything new.

23. How many one night stands?:

Again none. A somewhat laughable question for me I think.

24. What were your favourite TV programmes?:

I’ve watched quite a lot of telly in the past year. I love Only Connect – a fiendishly hard quiz, although I have gotten more used to it over the years and it doesn’t seem quite as hard as it used to be.

I enjoyed Sky1’s Must be The Music – it’s a blatant rip off of all TV talent shows, only the people involved had raw talent, write their own stuff and there is no stupid false drama involved. Dizzee Rascal, Sharleen Spiteri and Jamie Cullum judged it and were really good too. The girl that won – Emma’s Imagination was amazing.

I enjoyed Single Father, Lip Service, Mad Men and various other things this year too.

25. Do you hate anyone now that you didn’t hate this time last year?:

No, not really. I don’t tend to “hate” anyone. I try to avoid people I don’t like.

26. What was the best book you read?:

I read a lot more in the summer than I had in the past few years, but it has tailed off again since autumn. I read 1984 for the first time (ridiculous I know) which was awesome. I enjoyed the Stieg Larsson books (me and everyone else, then!). A Woman in Berlin was interesting too – I picked it up in the airport at Krakow and it was weird to read it only a few days after being in Berlin.

27. What were your greatest musical discoveries?:

I have listened to a lot more music than in the last few years, but I’m not sure how many of those things were new discoveries as such. I’ve enjoyed a lot of female pop and singer/songwriters this year – Ellie Goulding, Marina & The Diamonds, Laura Marling, KT Tunstall, Little Boots, Regina Spektor – although the latter few are hardly new discoveries.

28. What did you want and get?:

I guess some improvement to my mental health is the obvious thing. Getting my drivers license back is pretty good too.

29. What did you want and not get?:

A magic wand? I try not to want too much so I don’t get disappointed.

30. What was your favourite film of this year?:

I saw quite a lot of good films this year. I probably enjoyed Scott Pilgrim most. The Girl who kicked the Hornets Nest was good although I didn’t think The Girl who Played with Fire lived up to my expectations set by the book or the first film. Kick Ass, Toy Story 3 and Winters Bone are also contenders.

31. What did you do on your birthday, and how old were you?:

I was 24 this year. I had only just come out of hospital. A few of my friends and two of my aunts who live locally all went out for a meal. It was really tasty.

32. What one thing would have made your year immeasurably more satisfying?:

Mental Stability? – I’m surprised that this was part of my answer in 2007, which was long before I was diagnosed with any mentalism. It seems strange to me that at the end of what was a great year, I was still wishing I’d been a bit more stable and spent less time feeling low. I guess I’d somewhat forgotten that I was hardly stable before things fell apart in 2008.

I do think that being more stable and less depressed would have helped, but at least 2010 was an improvement on 200

33. How would you describe your personal fashion concept in 2010?:

I am not sure I do fashion concepts. I tend to wear jeans and some form of longish top or dresses over leggings/bright coloured tights. Now I’m back at work a bit I’m definitely leaning towards the tailored dress look. My suits don’t fit properly any more – too big!

34. What kept you sane?:

I think what sanity I have can be mainly put it down to one thing – Reboxetine (plus Lamotrigine perhaps – I wonder what effect taking Reboxetine on its own would have).

35. Which celebrity/public figure did you fancy the most?:

This always seems like a bit of a silly question to me. I don’t tend to be attracted to celebrities because I tend to need to get to know someone before they become attractive.

I also have a pretty pathetic sex drive these days.

36. What political issue stirred you the most?:

I’ve tended to try and keep a distance from most political arguments of late, mainly because the amount of mindless Tory-bashing has wound me up quite a lot this year and a lot of my friends are raving lefties. I am neither a tory, nor a lefty, but I am getting fed up of the way that people seem to choose opposition for oppositions sake, rather than looking at what is right or wrong about a policy.

I do care a lot about welfare reform and the NHS, but I’m not opposed to changes in the system in the way that some people are. I think we have to face up to the fact that the current systems don’t work and something has to be done.

37. Who did you miss?:

I miss a lot of old friends. I have lost touch with quite a lot of people over the last few years and I’m not as close to others as I used to be. A lot of my uni friends have moved away since we graduated too, so although we still see them occasionally, it’s not the same any more.

38. Who were the ‘best’ new people you met?:

I’ve met some great new friends locally over the past year or so, but I probably couldn’t think of any one person.

39. Tell us a valuable life lesson you learned in 2010:

Things can get better and depression may not last forever, yet recovery is not a smooth process either.

40. Quote a song lyric that sums up your year:

I can’t think of one in particular, especially as my year has been up and down. I may come back to this. I’m sure something will come to mind as I’m listening to music sometime this week.

Actually.. I heard You Say Party – There is XXXX (within my heart) the other day and those lyrics fit my mood over the last month or so.

When the morning comes
And the darkness presses on all sides
When the morning comes
I’ll have to fight

I will have a think to see if I can come up with anything more accurate.

_________________

So there we go. Another year, another meme. 2010 hasn’t been all that bad, although it started terribly and went down hill again a little during the last few months. 2011 hasn’t started too badly aside from the terrible cold over New Years, so fingers crossed it will be a good year.

A proper post is on its way. I am trying to get it written. Lots happening at the moment though and I can’t keep up!

I feel crap…

I’ve got a much longer post in the making about returning to work and all that jazz, but right now I just need to whine. The other post doesn’t portray much of how I’m really feeling. It is about recovery, yet at the moment that seems like a strange concept.

I feel crap. Not just a little crap, but really crap.

I’ve been trying to avoid admitting this, but pretending things are okay never does me much good. Maybe if I’m more honest and accepting of how I feel, it will help to ease the pressure a little? I am trying so hard to keep functioning that I am probably making myself worse. I don’t know, but I need to do something and I hope that writing about it will help for a moment.

My mood has dropped. Not just a little bit, but a lot. I could feel depression creeping up on me again, but this past 10 days or so have been far, far worse. During the past week, I have felt worse than at any other point in the last six months. My mood slumped at the end of September /early October, but it didn’t slump this far or this fast. Things had picked up quite nicely since then (and the increase in Reboxetine) and I thought it was just a temporary blip, but now I feel awful and I’m less sure it will be temporary this time.

Every morning is a real struggle at the moment. It is hard for anyone at this time of year, waking up when it is dark and cold outside, but this is more than just winter blues. When I wake up from yet another night of broken sleep and nightmares, I feel the familiar cloud hanging over me. It is a cliché, but it is definitely there, dark and cold, looming over the bed. I realise that it’s back. Depression is here and I am hit with a daily dose of disappointment that I haven’t woken up feeling any better. The sense of dread about yet another day hits me and I want to hide under the cover and never come out.

I know I need to keep functioning and I am forcing myself to keep going, but it is getting harder. On some days I have to go to work and there is plenty for me to do the rest of the time, so I have no choice but to keep going. I force myself out of bed, but it is getting later and later and the incentive to do so is diminishing. I was making myself get out of bed by 9am at the latest, no matter how badly I’d slept the night before, but I can’t do that now. Most mornings I am forcing myself up at 10am, but it was later than that yesterday. If it carries on like this, before long it will be lunchtime before I usually get up. I am doing my best to stop that happening.

I feel guilty when I am like this. I chastise myself for being lazy, but I don’t want to be. I just can’t find the motivation to not be. I know the bloke would chastise me too and that makes me feel more guilty and makes me want to hide how I am feeling. It is nearly always the motivation that goes first. Motivation is tied to noradrenaline and that is what the Reboxetine is meant to be working on, but it doesn’t seem to be doing enough at the moment. I need to get it back, but even forcing myself to do things isn’t likely to help much. It will just tire me out and make me frustrated when I can’t seem to cope.

I am still going to work. I refuse to admit defeat on that. I can’t give up on work. I don’t want to let people down and I don’t want to admit that I can’t cope. I’m worried that everyone will blame this relapse on work and say that I can’t do it. Maybe work is to blame, but I don’t see how it can be. It is not stressful and I was enjoying it at first. It felt really good to be going back and I had definitely missed it. I was being careful not to push myself too hard. My four hours a week were going really quickly, but as my mood has dropped, time has slowed down to a crawl and my last few shifts have felt excruciatingly long, despite being so very short. I have been struggling to find the motivation to go as well and have arrived late a few times because I had been putting off getting ready. My concentration appears to be slipping and I have to keep stopping to remind myself of what I was meant to be doing. I had run out of work the other day as well, so it felt like a complete waste of time and boredom was not helping my mood, but I have now got something new to do, which made it a little easier today.  I will manage though. I have to.

I am struggling to do much else at the moment though. Fighting depression and carrying on with work is sapping all my energy. There is housework to be done, but I am trying to get by with the bare minimum. I sit and stare at the laptop, but I don’t do much with it. I am barely bothering to read blogs or even the news at the moment. I spend too much time hitting refresh on facebook or hotukdeals, because they require little attention. I leave emails unanswered or unsent because I can’t concentrate long enough to write them properly. I am trying to knit a hat for my sister’s Christmas present, but it is slow progress and I keep making mistakes, despite switching to an easier pattern. I tried to go Christmas shopping on Monday, but I was so indecisive I barely bought anything and it took the whole day instead of the few hours I had planned. I have voluntary stuff to do – website updates and press releases to write, but I am putting it off.

I did manage to cope with fundraising at the Christmas Fair on Saturday though, which was a relief. I had been dreading it because I didn’t know how I was going to cope. Adrenaline helped get me through the day, which was a long one to say the least, but I survived. I was working with a decent bunch of girls for most of the day, so at least I had some support and there were plenty of yummy cakes to cheer me up, but I was flagging by the end of the day. We raised a decent amount of cash, which I guess makes it worth it. I felt completely frazzled afterwards though. I had to go out for the bloke’s work do in the evening, but I was exhausted and didn’t really want to go. I did and it was a nice enough evening, but I think I’m still recovering from the late night and long day. Everyone else was drunk too and I was driving, so that didn’t help me enjoy it. My head was so fuzzy, I have no idea how we got home safely. Not good really.

I curiously did the PHQ-9 and the BDI the other day, because I saw reference to the PHQ-9 somewhere and I suspected my scores would show I was depressed again. Scores of around 20 and 30 respectively puts me right on the Moderate-Severe threshold on both scales. I don’t believe that it has got that bad so quickly and I think severe is pushing it, but moderate depression is probably a fair assessment at the moment. Strangely, my scores are worse in different areas to where they used to be, but it’s still higher than I had expected. My BDI score did get up to the late 50s/early 60s though when I was really unwell, so there is a long way to go before I get like that. I did a retrospective scoring for how I was during the summer, just to compare and I would have said my PHQ-9 was about 4 or 5 (not depressed/mild depression) and my BDI around 8 (mild depression?). Things have definitely gone down hill. I think my “natural” state is probably a little on the low side anyway, but this is more than that.

Physically I feel awful as well. Tummy troubles continue. I spent one afternoon last week rolling around in agony. The pain in my gut was just so bad and it came on so suddenly I didn’t know what to do. It was probably the worst attack that I have had and it took a few hours to settle down to a dull ache. My appetite was hit by it and still hasn’t really recovered. My bowels just can’t seem to find any sort of rhythm or pattern, no matter what laxatives or diet I am eating – eat eggs and I end up with diarrhoea, eat beans and I can end up constipated. It makes no sense at all.

In general, my body feels really run down. I have a cold sore and have had a few spots break out lately. I think I may have a urinary infection of some form. I’ve spent most of this week constantly needing to wee, although thankfully it hasn’t felt burny/stingy, so I’m not sure. Last night, a lymph node at the back of my head (behind my right ear, up from my neck) has swelled up and it is really painful. It feels like someone has hammered something into the back of my head and that they are constantly notching up the pressure. I couldn’t sleep at all with it last night. I had the same thing happen on the other side a while back and it took a few days to go down. I hope it does soon. I am not sure how much longer I can take this.

I went and saw Dr N this evening. I was hoping he could at least suggest something to fix my body, if not my mind. Sadly he didn’t have much to offer either. That may be partly because I didn’t know what to say to him. I didn’t tell him all that I wanted or meant to. I seem to have forgotten how to talk about this stuff and I keep forgetting things I should do or say.

He asked me what had triggered my mood. I said I didn’t know. Possibly the time of year, but I’m not really sure. He asked what support I was getting from the CMHT. Nothing is the answer I gave and the truthful one too. I had a phone call last week to tell me they’ve “closed” my case, because I no longer have a worker. They had forgotten to sign off my old CPA when my social worker C left, which was back in June, but someone had found it and said they would send it off to me so they could close my case. Dr N had received a copy too, remembering that there was an apology attached to the front. I don’t know what he thought about that. He asked what other support I have. I reminded him that I am still seeing Dr M as an outpatient, but I won’t see her until January now. He asked about the psychology referral. I’ve not heard anything. He sighed at that.

He mentioned that her last letter suggested that I drop the Reboxetine a few days a week to see if that helps the side effects. She suggested either going every other day – 6mg one day and 8mg the next or even 8mg in the week when I have to work or am at home alone and 6mg at weekends when I have more support. Dr N said he thought the latter may be worth a try, because he hopes that improving how I feel physically may ease my mental symptoms too. He doesn’t think 6 or 8mg will make that much difference either way to my mood, but it might help with the tummy troubles. I am not so sure about the idea, especially in light of my dropping mood. In fact, I’d even tried a few days on a slightly higher dose – 10mg (an extra half tablet), just to see if that could kick my mood back up quickly. No such luck though. I guess it is worth a try.

I didn’t know what else to say to him and in the end we just wished each other a good Christmas and I left. I walked out and finally started crying. I’ve needed to for days, but the tears hadn’t come. I don’t know what to do to stop this decline and I don’t feel like I have anyone to help me. I am scared about Christmas and January and all the memories that this time of year is dragging up. This time last year I was telling myself I just have to get through Christmas. I am doing the same now. The problem is, last time I got through Christmas, only to try and kill myself when January came. I don’t want that to happen again. I am not as bad as I was back then. Things have moved on a lot in the past year. I have hope that my mood can recover again, where as last year I had no hope at all, but I am starting to feel more and more helpless and I fear that I will always be waiting for the next relapse. I am terrified that every time I try to live a normal life, depression will come back and bite me. I don’t want that to happen. My mood has to pick up soon. I need to keep going.

This only seems to scratch at the surface of what I am thinking right now. I am scared. I am worried about what everyone will think. I don’t want to let everyone down. Everyone has been so pleased about the progress I had been making and seemed to be excited about me getting better. I had been so pleased too. I thought I was getting my life back. I am going back to work at last. I am driving again. Everything seemed to be getting back to normal. Things seemed to be going really well. Then I am hit with this slump in mood and I don’t know what to do with myself. I know recovery is a difficult process and I’m always going to have set backs, but this feels different. It isn’t just a bad day or two. Nasty thoughts are creeping back in. I am having to put on my happy face. Life feels like a struggle, rather than just being life. I hope it is just a blip. I really do.

I’m also scared about the diagnosis stuff being stirred up. I was recovering, medication was helping, my condition wasn’t pervasive and untreatable, so I couldn’t have had a Personality Disorder. If I’m getting ill again then people will probably start thinking that it was just a co-incidence and that I do have a PD after all. Maybe I am being paranoid, but I am scared about this. I was glad that I had responded to medication. I may have been treatment resistant, but at least I was treatable.  Now I just feel like a failure. It will be back to the theory that I need therapy if I am ever to recover and I will be blamed for not recovering. No doubt I will never get offered therapy anyway, even if I need it, but I was hoping I didn’t need it. I don’t know. I don’t want to think about it. Whenever I think about what went on earlier this year about my diagnosis I get panicky, anxious and upset. It seems to hit a nerve and I have to stop thinking about it.

I hate feeling like this. We will see how things go. At least I have admitted it now. I have been carrying around these thoughts like a guilty burden. I have been secretly acknowledging the depression, whilst denying it in the hope it would go away and that no one else would find out. I feel like I am letting everyone down. I wanted to have a “happy ever after” for this blog and then I’m back here again whining about depression again. That isn’t what I wanted. Sorry.

Phased Return…

So last week, I finally met up with the HR manager to discuss Dr Occy Health’s latest report and we have agreed that I can begin a very slow phased return.

I am starting with 2 hours a week on Tuesdays and Thursdays. I will be doing this for the next few weeks until I see Dr Occy Health again in December, when we will review again. All being well we will add a few more hours to each day and eventually extra days until I am back full-time, but I have been told to expect this process to take many months. I have no idea if I will be able to cope with going back at all, but it is time to try. It has to be a case of seeing how it goes and hoping that the transition is smooth.

It’s more than two weeks since I saw Dr Occy Health and our discussion about how I may go about a return to work. He seemed reluctant to try and push me into anything more than I was already doing (the occasional short visit), but I asked about formalising something more and he agreed I could begin with a slow phased return. He set some guidelines, but said I would need to arrange the details with HR, rather than him prescribe anything more definite.

The guidelines suggested that I am restricted to a maximum of 15% of normal hours at first. I didn’t ask him if he meant contractual hours or realistic ones, but I suspect he meant the former. It would mean quite a big difference – my contractual working week was 37.5 hours, but realistically I did anything upwards of 50 hours. I don’t think I will be allowed to do those sort of hours again though. Essentially I am restricted to a maximum of 5 and a half hours, which I guess seems reasonable, although of course I am only doing 4 at first. I don’t know how long this restriction is meant to last – the first week, first fortnight, first month? It looks like it will be at least the first month though and possibly even until the new year.

He suggested I start my working day during late morning, which suits me fine. I am usually at my most stable in the middle of the day and I am not used to early starts any more, so it makes sense for me to try and work when my mood is best. It also gives me the chance to take the dog out and get anything else that needs to be done beforehand.

Whereas over the summer my mood was consistently on the low end of normal and hardly ever changed, since the slow decline in my mood during late September and the subsequent increase in Reboxetine, my mood has been fluctuating a lot more. I am having good days and bad days, rather than lots of okayish ones and my mood is varying during the day too. Over the past month, my mood has been largely following the classic depressive cycle of feeling worst in the morning and mood improving throughout the day. I am waking up feeling pretty depressed each morning, but by lunchtime I am usually feeling okay. By evening, I am often feeling agitated or edgy, which is also not conducive to work either, so not leaving work until too late in the day is probably wise. Occasionally I’ve had a day that has gone the other way around or the morning depression has lingered long past lunchtime, some days are just crap all round, other days are absolutely fine. On the whole, I think the increase in Reboxetine has brought my average mood up again, but I am less comfortable with the instability that has come with it. I don’t know how I am going to feel from one day to the next and I find it harder to plan what I’m going to do, because one day I will be able to get loads done and the next I can’t face getting up. My mood isn’t really getting to the extremes, but it’s wobbly enough to be problematic.

Alongside the fluctuating mood, is also a fluctuating, but omnipresent level of anxiety. Most of the time I don’t even know what I’m anxious about, but I just feel the physical presence of anxiety lurking in my chest and a niggling worry about something in my brain. Sometimes that physical presence is a lot more than just a niggle and I feel physically sick, my heart keeps skipping a bit and I feel dizzy and shaky. I am getting a lot of nightmares too. Often I don’t know why this is happening. Sometimes the cause makes itself very clear and I can’t stop thinking about it no matter how much I try. There are plenty of worries about work, how it affects my benefits and finances, my tummy troubles, medication, diagnosis stuff and other stupid things like “what am I going to knit next?” floating around, but they shouldn’t be enough to prompt the level of panic I’ve been experiencing.

I don’t really know where this anxiety is all coming from, because until fairly recently I’ve not had much of a problem with it. I am usually pretty good at managing my worries and very rarely have I experienced the physical symptoms of them. Anxiety was always tagged alongside my list of diagnoses and I was often sent to “Anxiety Management” at The Priory, but I think that mainly came out of an assumption that all depression comes with anxiety and not because I actually experienced it. I can use those anxiety management skills and rationalise my worries and thoughts, but I don’t seem to be able to beat away the physical results. I have been taking Propranolol for months and that is supposedly meant to reduce agitation and anxiety, but I don’t know if it does much good. Reboxetine is known to increase anxiety, so it could just be that, but I am loathe to attribute everything to the damn drug.

Anyway, we shall see how I go with my working hours. I think if I stick to the middle of the day I will be okay. I don’t think there is anything stopping me going in a bit earlier or later if I want so if needs be I can do that, but I think it’s important I try and stick to a routine and get used to going to work at a specific time. I don’t know what will happen when I need to increase my hours or which end of the day it would be better to add to, but we will come to that when it happens. Having a routine and going in at regular times is one of the things I am going to need to adjust to. I’m not sure I’m up to doing stuff whenever I have to, rather than just when I feel up to it. When I’ve had chores I really need to do and am having a bad day it can make things a whole lot worse, so I hope I can manage.

Another guideline suggested that whatever I do is non-client facing. This is pretty important to me at the moment, because I can’t deal with the stress and responsibility that goes with working directly for the client. I am having to remember how to communicate in the world of business and not the world of mental health services or just with my friends. I think it is going to take some getting used to. I don’t know what to write in work-related emails or how to talk to people any more, so I’d rather keep my communication with others down to a minimum until I get used to it. At least if I make an idiot of myself with a colleague it’s not going to get me fired, but say or do something stupid with a client and I could be in trouble.

This is actually something that upset me during the HR meeting. The HR manager said she was worried about how I am going to cope interacting with others in the workplace. She remarked that observing me at the community meeting I went to the other week, she was worried that I was too honest and open with people and she is worried that my openness will shock people. She said she doesn’t want me to stand out too much or give people the wrong impression. I don’t think I said anything other than that I’d been off work for a couple of years due to illness, but I am currently in the process of returning to work. I didn’t elaborate on what kind of illness I’d experienced. I only said that because we were asked when we joined the company and what client we were working with at the start of the meeting. If I didn’t explain that I’d been off for a while, it would look like I’d been passed over for promotion a couple of times and that I wasn’t chargeable to a project, which I think would have been more embarrassing.

I’m not ashamed of the fact I’ve been ill and don’t see why I should hide it from people. I didn’t mention mental illness, but even if I did, it shouldn’t be a problem. I’m sure nobody would be telling me not to tell people that I’d been off work if it had been cancer or a heart attack keeping me away, so why do I have to hide it because I’ve been off for mental illness? I don’t intend on telling everyone the whys and wherefores, but questions are going to be asked or assumptions made unless I say something. You can’t just ignore two years of my career that have just disappeared. The gap in my company CV and in my client history is plain for everyone to see and the fact I’m still at my current level over 3 years after joining, also points to some kind of problem. I don’t see what is wrong about being honest about the fact I’ve been on long-term sick leave. I don’t know what else I’m meant to say. I have no intentions of lying or deliberately hiding the truth.

She said I should treat it like starting a new job and I should remember that I will be meeting new people all the time and they don’t know my history, so I should feel no reason to tell them. I understand this and agree, but the problem is that there will be plenty of times that my absence will be obvious. My company start date and level is on my people profile and my CV is on the system for anyone to see. The question of what client I am working on or have worked on in the past is going to come up. People I have worked with in the past will see me and ask where I’ve been. People will see me arriving and leaving the office at strange times, only working for a few hours and doing pointless tasks. I can’t hide things forever and I see no reason why I should, especially as I don’t have to worry about HR finding out, resulting in me losing my job. HR know the whole grizzly story, so there is no reason to hide. I will have to be honest with whoever I work with next, because I will be working reduced hours.

I was really quite upset by this comment and it took a lot to bite back the tears that were threatening. I knew I couldn’t break down at that point, because she would never think me well enough if that happened. I really would look like an overly emotional mental person if I burst into tears in her office and it would confirm all of her worst fears, so I did my best to maintain my composure. She thinks that I’m not able to act professionally and deal with people’s reactions and of course her comments do feed my own fears and anxiety. I am scared about what I will say, but I have thought about it a lot and see no option but to be honest. If they aren’t happy with that, then it is their problem, not mine. I know I am going to have to get used to this kind of thing, but it hit a nerve. I worry I will be faced with this dilemma for the rest of my life.

I’d asked Dr Occy Health if he thought I should or could go to the all-day community event and Christmas party in London. I’d like to go because I have missed out on the last couple of years and the meetings are usually interesting. I think it would be a good opportunity to find out what is happening in the company at the moment and the party should be fun too! I was a bit worried about the fact I will be travelling down to London on my own and it may be a bit much, but I think I will be okay. Dr Occy Health agreed that it would probably be good for me and said he would put a comment supporting my attendance on his report.

HR Manager was less keen on the idea. She was worried about me travelling to London on my own and is worried that I won’t cope with meeting everyone. She seemed worried about how it will look if I manage to attend a whole day event and a party, yet I’m only able to work four hours a week normally. People may judge me for it. They may, but it is a bit different spending a day listening to someone else talk than actually having to do proper work and very few of them will know I’m working reduced hours anyway. We have agreed to take a call on it next week, so we shall see what she says. I don’t know what is the right decision, but I’d like to go if I can.

I can’t remember what the other guidelines said. I think they probably mentioned local working and having a local manager, but I’m not sure. There was a note about me being protected by the DDA and the fact that these could be considered “reasonable adjustments”. Finally it was noted that I should be reviewed by Dr Occy Health in early December.

I hope I can manage. I have survived my visits so far, but I think it will get harder when I have to tackle some proper work. I have run out of initial tasks now, but HR Manager talked about the possibility of me doing some work for her. There’s a project she is considering that is related to something I did on a previous role, so I may be able to help with that, but I don’t know yet. I’m just waiting to see what she suggests.

At the moment it is a bit frustrating. I feel weird when I arrive at work so late and have to leave so early. I worry what everyone thinks of me. I generally feel okay whilst I am working, but I struggle either side of it. Strangely, one of the weirdest things is wearing smart clothes again. I am not used to it.

I wish I could fast forward to being back properly, but sadly that is not an option. I have been off work for nearly two and a half years though and I know it is going to take a lot of adjusting to go back. Dr Occy Health keeps reminding me of this and I think as far as he’s concerned, it’s a miracle that I’m trying to go back at all. This is somewhat disheartening, but I know the statistics and he must see enough people that never make it. I hope I can be one of the lucky few.

Anyway, I must stop writing now. I always finish blog posts like this, but I never get the chance to say everything that I am thinking at once. I have been writing this on and off for days anyway, so it’s time I posted.

Tummy Troubles…

I am still struggling with the tummy troubles. I have been taking the higher dose (120mg TDS) of Alverine Citrate for a few weeks now and I do think it has helped a little, despite the fact I have also increased the Reboxetine to 8mg in that time. I was getting less cramps at least, although I was still having problems with diarrhoea or constipation all the time. My appetite had improved a little, which must suggest things have been a little better.

Unfortunately that slight improvement has been completely negated by the events of last night. A warning – this post definitely scores high on a rating of too much information!

I had been feeling fine and had enjoyed my dinner of roasted ham, mash, kale and carrots. As I was getting ready for bed and just settling down to watch Newsnight, I got a sudden shooting pain in my tummy and next thing I knew I’d had a somewhat messy accident. :S :( I was so shocked and upset, it took me a second to act and jump into the bathroom (which is within a metre of the bed), although by this point it was far too late anyway. The bloke was horrified and just shouted at me, called me disgusting and hid in the back bedroom, whilst I stripped the bed and took a shower. :( I was feeling pretty rough by this point and thought I might be sick as well, but managed to keep that end under control! The bloke eventually realised I wasn’t very well and that he was being unreasonable and he apologised and started to make the bed. I didn’t know what to do with myself. He wasn’t going to let me in the bed after that, so suggested I got the air-bed out! At least that is plastic and cleanable in case of further episodes. I didn’t expect to sleep much anyway, so decided to do this and settled down under the spare duvet on the lounge floor.

I was awake most of the night and felt pretty rough, but managed to survive without any further accidents. I’m still feeling pretty dodgy now, although by now I could just be hungry. I am too scared to eat anything though.

I don’t really know how to say this, but the poo didn’t look good at all. Very dark brown, sticky, runny and lumpy including some undigested carrots. Not nice at all. The fact it happened so suddenly suggests things aren’t very happy in there either. If I could have done anything about it, I would have. There was no warning at all, except for the shooting pain that came with the attack. It literally came out and exploded like the lid off a pop bottle that had been shaken up. bleugh. Sorry. You don’t need to know that.

The bloke wanted me to book an appointment with Dr N, so I am seeing him this afternoon. I am not sure what he can say or do. I have no idea how I am going to tell him without dying of shame. Part of the reason I am writing this, is to practice describing what happened! I am far too British and shy to talk about poo. Even with a doctor. It has been hard enough to tell him of my tummy troubles so far, but this is an extra level of embarrassment.

I wasn’t sure about writing about this here as it is so embarrassing, but it is the latest thing to happen in the whole tummy troubles saga and something so horrible seemed worthy of note. After all, this blog is an account of some of the more grim elements of mental health. Coping with the side effects of medication is a big part of dealing with mental illness, so I may as well be honest about it.

My bloke was very shocked and not very impressed. He wants me to stop taking the Reboxetine if that is what is causing this. He said he doesn’t like living with an 80 year old. I agree. I don’t enjoy feeling like one.

I had been struggling with the increase in dose aside from this. My sleep has deteriorated and I only find I can sleep properly when the dose wears off in the morning, when I should really be getting up and taking the next dose. It takes ages to get to sleep, I am waking up all the time and struggling to get back off to sleep and I am having nightmares and feeling restless. It is exhausting. I was getting palpitations at night too, immediately after the increase, although that seems to have settled down a little after a couple of weeks at the higher dose. I felt really low in the first week or so too, but that also seems to have improved over the last couple of days, so maybe it is starting to have a more positive effect now. That said, I feel crappy today after the night I’ve had!

I am too scared to stop the Reboxetine though. I don’t want to go back to how I was before. I don’t want to end up really depressed and suicidal again. The perpetual low mood and vague depression of late is draining enough, but that constant despairing depression is much, much worse. I don’t know what alternatives there are. Maybe I should just go med-free and sod all the drugs and their stupid side effects. I still wonder if my mood would have resolved itself a lot faster if I hadn’t have started taking bloody medication. Then again, it may have killed me first.

In good news. I got my driving license back!

I now have a 1 year license, so I need to stay sane over the next year or I will lose it again. Apparently, I will get a form 3 months before it expires to request a renewal. They will go through the medical enquiries again and decide if to reissue. No doubt it will take 5 months again to do that, so I will not be able to drive again for a wee while, but I guess we will see how it goes next time. If I get worse or am told by my doctors to stop driving for whatever reason, I have to let them know and presumably I will have to wait months for them to decide again, so I hope that doesn’t happen.

It is great to have my car back. I am looking forward to going places and having my independence again. I think it will make a big difference in helping my recovery. Being able to go where I want and not having to rely on public transport or lifts from the other half is going to be a massive help. I have a lot more choice about what I do with myself and will be tempted to go out more.

I had a drive on Saturday afternoon after I’d insured and taxed it and it didn’t feel too strange to be back at the wheel. The bloke went with me and we made it in one piece. My left arm has remembered where all the gears are and it felt pretty natural, so I am glad I hadn’t forgotten it all.

On Saturday night we went out in my car and got pulled over by the police! I wasn’t driving, the bloke was. It had flashed up on the policeman’s dash that the car was uninsured – obviously the database hadn’t been updated since I had only insured it that morning. I am glad I wasn’t driving or I’d have panicked. I would say I’d have shat myself, (I think I did on Saturday night!), but I’m not sure that’s appropriate now! *blush* At least we can say the police are on the ball! We were off to a beer festival and although my bloke was only going to have a pint as designated driver, we decided not to take the risk of being pulled over again later, so we left the car and got a taxi back. We went back to get it on Sunday morning and I took my first solo drive, driving my car back. I was okay, although I had forgotten which lanes I needed to be in a couple of times, so I made life harder for myself.

Anyway, I need to get ready for my doctors appointment. I haven’t got dressed yet and am just lying on the sofa with a blanket. Walking around makes me feel worse, so the temptation is to lie here all day. I have a meeting to go to this evening though, so will have to get up eventually.

Edit (3pm): Appointment with Dr N was very embarrassing and not too much help. I had been taking senna daily, plus the occasional dose of lactulose to counteract the constipation I was struggling with, but he thinks that won’t help on the maintaining control front, so I should stop that for now. If I don’t take it, I usually end up in pain and bloated from the constipation within a day. He has given me a script for something else to take if that happens, so we shall see how we go.

We talked about coming off the Reboxetine, but he didn’t think that was worth the risk at all. We don’t know if my mood picked up spontaneously or if the Reboxetine helped, but either way, my mood is a lot better and it doesn’t seem wise to mess around with it. I may have to drop the dose to 6mg if the problems persist, but I was struggling enough on that dose, so don’t suppose it makes much difference.

We talked about sleep and he asked if I wanted to try more sedatives, but neither of us really saw the point as they don’t seem to help all that much. He made the suggestion that actually getting back to work and having more brain stimulus may help, which in theory is true, but I never slept that great when I was at work. Even when I have been busy lately, it hasn’t made any difference, so I’m really not convinced by this. If anything if my brain is busy during the day, I really struggle to slow it down at night, especially if I get anxious too.

Mentioning work, I told him about seeing Dr Occy Health again on Thursday. He thinks I should push to agree a planned return to work as having a structure and plan may help give me something to aim for. I think he is right, although I am wary of the risk of too much, too fast. I told him about going in a couple of times and he agreed that was promising, although I also said that my work are very hesitant to let me rush back. They are being very cautious about how much I can do and when I can do it. I actually got told off for doing work-related activities whilst I was there the other day. We will see though.

Off to the Office…

Friday 15th October – 11.05am

(I started this post on Friday, whilst waiting for the bus. I didn’t get the chance to finish it, so I am going to post what I did then and complete the post before publishing it all together).

I’m sat at the bus station writing this on my phone, waiting for the bus that takes me to the office. I missed the connection as the bus from my village was running predictably late, so I’ve got a 25 min wait for the next one. At least my renewed disabled bus pass arrived before I got the bus this morning, saving me about 6 quid in bus fares today.

I am nervous. This is not the first time I’ve been back since I’ve been ill. I got over that hurdle a couple of weeks ago, but it doesn’t feel any easier a second time. On my last visit, I went to a meeting I was invited to. I used to be on the office forum, which focussed on employee engagement and office morale. The committee had stopped meeting after I went on leave, but the Senior Exec who was in charge decided it was time we revived it, so I was invited along. I thought it was probably a good way to get updated on the situation in the office and to do something work-related without too much pressure. It helps that I have a lot of experience in this area from my last role, so I thought I could handle it. Plus there was free breakfast so how could I refuse? I feared that a meeting with two Senior Execs and a handful of others might have been a bit much for my first trip to the office in two years, but I decided it doesn’t really matter what they think of me. Dr Occy Health didn’t expect me to go to the office to do any actual work, but I decided that it would probably be easier if there was a purpose to my visit and chatting about charity work and office parties didn’t seem like too much of a challenge.

At the start of the meeting I explained that I had been off on sick leave for a long time and that I was in the process of getting back in touch with work, with a plan to start returning part-time soon. I wasn’t sure about doing this at all. I don’t know if it is a good idea to have too many people knowing about my situation and I felt quite self-conscious, but I think it helped to set expectations and put my comments into perspective. I think I would have probably come across as strange if I didn’t put things into context. I am very behind with the latest news on clients and projects! Over two year’s absence can’t really be left unexplained.

I think I handled the meeting okay. I had things to say and as the only person there from my level, I could offer a unique position. This made me feel a little more useful than perhaps I had feared beforehand. I think if there were others at my level, I would have been tempted to stay quiet and I would have felt surplus to requirements, maybe even a hindrance. Compared to others, it would have highlighted how out-of-date I am. I also struggled to remember things, partly because it is so long ago and partly because my brain has been fried by depression and ECT. I had to think hard about how things were back then and what I would have said 2 years ago and it made it a struggle to keep up at times. Things have definitely moved on whilst I’ve been away (for example, the client I worked for last, is no longer a client), but reassuringly we were still discussing and facing many of the same issues we always have. The stuff I had remembered, was still valid and I still had relevant answers to give.

After the meeting, I took a hot-desk for an hour or so and started to trawl through my old inbox. I decided the best strategy was to skim-read subjects and mass delete. A request from two years ago is hardly likely to be valid any more, so I assumed it could be ignored. There were a few automated notices I had many, many times over, so I thought I better look at sorting those out. I sent a couple of emails to old colleagues to see if they could point me in the right direction, but most of the people I would have asked, have since left the company. Hopefully, someone will be able to help me stop them from coming though. Pretty much everything else went in the trash. I have probably missed a few things, but the chances are that if it is important, they will ask again.

I was struggling to keep my mind on the job. Part of this was probably a lack of concentration, but I think a lot of it was just down to how I felt about being back. I was reminded of how much I’d missed and what had happened before I went on sick leave. My mind was wandering back to those times and thinking about what happened and what went wrong. I felt a bit strange when I came across some old emails. Stuff from when all of this kicked off. Emails to HR and my old line managers about how I was feeling, what occupational health had said etc. I wish I hadn’t seen them really. I don’t want to go back down that road.

It was also weird to discover how much has moved on. So many of the old systems have been superseded and I have no idea where to start when I sign in. So many of my colleagues have gone, been promoted, moved client, moved office. I will have a lot of catching up to do when I get back. I will need to re-learn a lot of things and it will almost be like starting a new job, even more so because I will be starting a new role with a new team. I am worried though that with a year’s work and 3 years in the company under my belt, people will expect me to be experienced and know what I am doing, but I’m not sure I do any more!

I felt somewhat weird about the whole visit. On the one hand it was fine. I coped, I took part in the meeting, said something worthwhile and I don’t think I made an idiot of myself, but on the other hand I felt really out of place and uncomfortable. Despite the fact the meeting went okay, I have no confidence and I worry that I can’t do that job any more. I don’t have the confidence or the concentration. I am scared of going to meetings, talking and working with others, having to make decisions and everything else that comes with the job. I just don’t feel up to it.

The culture feels really alien too. Just wearing smart work clothes felt wrong. I used to love wearing my sharpest suit and heading into the office. I was happy when I drove through the office gates and walked in, laptop and security pass in hand. Work used to feel like the right place for me. I was good at my job, I knew that I was and I really loved it. Now I feel lost and out-of-place and uncertain if it is the right thing for me any more. When I walk in to the office now, I feel like someone who has got lost and ended up in the wrong place. It feels like there are all these people staring at you, wondering why you are there and thinking that you’re an idiot. I worry about looking confused, forgetting where things are or what the etiquette is. For months, the only people I really dealt with on a semi-professional level were doctors, psychiatrists and the like. That is a very different relationship to a working one. You don’t sit down with your manager and pour out your inner woes. You have to maintain a professional front, appearing calm and capable, even when you feel like crap and really want to hide under the duvet or break down and cry. I am not sure how long it is going to take me to adjust.

There was a small part of me that got a real buzz from being there though. There was a little spark of excitement at the thought of going back to work. Being there and taking part in that meeting, really reminded me of what I’d been missing. I like a challenge and to use my brain. I’ve not used it enough lately. I enjoy working with people to come up with ideas and I like to get involved with solving problems. It is good to feel like you are useful and to have something to focus on and think about. When you enjoy your work, it can be the thing you live for. I didn’t really want to leave the office and go home afterwards and it was hard to pull myself away at the end of my permitted two hours. I wanted to stay and work and be normal for a while. I wanted to forget everything that had happened over the past two years and just get on with my career and my life. I didn’t want to be ill any more. I don’t want to be ill any more.

I’m nearly at work now and staring at my phone to type this on the bus is making me feel queasy. I’m only going into the office for a couple of hours today. There’s no real reason for my visit and I could do what I intend to do there at home, but I thought it would be a good idea to try to visit again. I’m going to sit at a desk, read through emails and try to update my company CV. I don’t know how much I will get done, or what I will be able to do, but it is worth a try. After all, Dr Occy Health didn’t want me to try to actually work, so just being there is a good start.

Afterwards…

(I have written the rest of this post over a couple of days, so I will do my best to complete it and publish it now).

After my first visit to work – that meeting I wrote about above, I was completely drained by it. As I left the office, my mood started to crumble away from me. It was almost as if by leaving the office and getting back on the bus, I was leaving behind the normal world and going back to the mental one. My mood seemed to change accordingly. Whilst I was at the office, my mood was okay. I pretty much switched off my emotions and got on with the task in hand, doing my best to act normal and remember how I used to be at work. It didn’t go too badly, so I was hoping it was fine and that I had nothing to worry about. Unfortunately though, afterwards I felt really rubbish. I guess I had been maintaining the front and this can be exhausting.

It was really hard going back to the mental world. I didn’t want to. I wanted to stay at work forever and not go home. Being back at work gave me a few hours to pretend that everything was normal. It was almost possible to pretend that none of the past two years had happened. I was back at work, doing a job that I loved. I could forget the world of therapy, medication and psychiatrists and distract myself with a world of email, meetings and spreadsheets. Two and a half years ago, I was using work to distract myself from anxiety, suicide and a mood disorder, within half an hour of arriving at the office, I was doing the same again. If only that distraction and front could be maintained.

I was really anxious afterwards. I dissected everything a million times over. I went over everything I could remember from the meeting, to check I didn’t seem too mad or make a complete fool of myself. I have always worried about how I came across at work, but usually I could be fairly rational and pragmatic about it. Evaluating your own performance is a big part of the job, but it is not good to spend hours catastrophising, pulling apart everything you have done and then using it as a stick to beat yourself with. Unfortunately this time, my evaluation was definitely closer to the latter. I knew I was doing it, but couldn’t seem to stop myself. CBT – where art thou?

I felt quite panicky about the future. I worry about whether I could ever do that job again and where I fit in. The drop in my mood, level of anxiety and complete feeling of exhaustion afterwards only made this worse, because it confirmed my worst fears – that I wasn’t good enough and that I couldn’t cope any more. I was annoyed with myself, because I didn’t see how a couple of hours could make me feel so bad. I was angry at myself for being depressed and angry at depression for taking my career away from me and stopping me from working. I was really disappointed that although the trip to work went okay, the fallout from it was less good.

My second visit to the office was not too different to the first, except I didn’t have a meeting to go to. I was actually a lot more nervous beforehand this time. I hadn’t been feeling very good mood-wise anyway and had very little sleep, so I was even more worried about what effect it would have on my mood. I haven’t been sleeping well at all since the increase in Reboxetine – I’d forgotten how bad it could be for insomnia.

I had emailed the night before to reserve a desk, but the woman was still grumpy when I asked her which one. I didn’t arrive until about 11.45, due to missing the bus, so I was later than I’d originally said. She said she had only reserved it up to that time, so if it’s gone it’s not her fault and I will have to do without. I did not like the idea that I will have travelled all that way and that I may not have had a desk to work at, but thankfully it was still free and I could set my laptop up and get to work. I had problems with the LAN though. I could get on the intranet, but no external websites were working, which seemed a bit strange. I managed to get on to the support website and worked out how to fix it, but it still ended up taking a lot of my time.

I spent most of the time going through the latest emails, including a couple of responses to my enquiries from my previous visit. Still didn’t have any answers, but I was a step closer to getting them. I did feel a little overwhelmed when I looked in my inbox and saw that in a few days I had over 3 pages worth. Considering I am on sick leave, so I am not getting anywhere near as many as I would normally, it was a little daunting. One of the biggest problems before I went on leave, was the fact I often felt like I was drowning in emails and there were times when I just couldn’t bring myself to answer any of them. I would check what I was writing a million times and would get a feeling of doom every time I clicked send, even when the message was a simple one-line answer. I would look at the list and not be able to summon the motivation to do anything about it. Certain names would fill me with dread, because I knew it would be more work.

After my inbox, I wanted to log in to my company CV, as it will need to be updated before I start looking for roles or internal work. It took me ages to remember where I needed to log in! Once I was in, I didn’t know where to start. It is obviously very out of date. I noticed the skills section doesn’t increment the number of years experience you have had, so decided that was a good place to start. There was a lot of skills missing and I didn’t even finish completing that section before my time was up. I wanted to stay and finish the job, but quite sensibly I had somewhere to be afterwards, which stopped me staying all afternoon. I felt really lazy arriving at the office just before lunchtime and leaving only a couple of hours later. I’m sure people were looking at me as I packed up and left. They must have wondered where on earth I was off to at 3pm. Leaving before 6pm is just unheard of, so that isn’t surprising.

I did feel a lot worse again afterwards, although probably less anxious this time. I didn’t spend any time talking to anyone on that visit, so I had no conversations to analyse afterwards, which helped I think. I literally spoke to the woman at the reception, took my desk, worked in silence and then got up and left. This is the way everyone works in that office, so I wouldn’t have seemed anti-social or anything.

I am still not sure how I feel about work now after dipping my toe in. I am scared that I won’t go back. I am worried that when I see Dr Occy Health in a couple of weeks, he will be concerned at my drop in mood lately and he will delay my return even longer. I feel very conflicted about it. Half of me is desperate to get back, to put the past two years behind me and to get on with my life. When I was at the office I felt okay and seemed to be coping, so there’s no reason why I wouldn’t cope for longer. I think it will be good for me to get back to work and feel useful again. I have been getting bored at home and feel very worthless. So much of my self-worth was tied up in my work and I think it still is. I will never feel like I have recovered or improved until I finally get back to work. I was a lot better over the summer and felt pretty well, but I still wasn’t at full capacity. I still wasn’t able to work.

Now, I am very scared. I am worried that I will not be able to cope. I am very worried that I will go full-steam ahead into a return and that in a few months I will be back to where I was. I will manage for a while. I can put up a front and get on with my job and everyone will think that I am fine, but it wouldn’t last. When I get to the office, even if only for a couple of hours, I feel myself going back to my old ways. I want to bury myself in work and feel the urge to push myself too hard. I don’t want to go home after two hours. I want to go back to full-time and to have responsibility again. I survived almost a year of overdrive last time, but I suspect it would only take a couple of weeks to break me again. Maybe even a couple of days. I worry that just a few hours of work makes me feel so terrible afterwards. That can’t be a good sign. Maybe my stamina would improve, but what happens if it makes me worse first? I have been wobbly enough of late, without needing any extra stress and pressure, so I don’t know if it is a good idea. Yet the thought that I may never get back to work makes me feel so worthless, I may as well just go kill myself anyway. I need to go back.

We will see. I am going to try to go in at least one more time before I go back to Dr Occy Health. I may try to spend a couple of hours working from home too. I am now checking my work email most days, which should stop that getting too overwhelming. Just ten minutes each day is a place to start, right? I need to have another think about what else I can do before I see him and what I need to ask when I go back. Sometime after seeing Dr Occy Health, I am meant to be meeting the HR manager who is looking after me whilst my HR rep is on maternity leave, so I need to think about what I will tell her too. I don’t know yet.

8mg…

I saw Dr M this morning. I’d not seen her for ages. It was back in July, just before I went to Europe (I haven’t written about my trip, but anyone following my twitter feed will know that I spent 2 and a half weeks InterRailing during July/August), so a lot has happened since then. She suggested that it was a good sign I hadn’t needed to see her sooner, but I indicated that it wasn’t especially. It probably would have been if I hadn’t have wanted to see her about a month ago. I couldn’t get an appointment then. This was the first Monday we could both do.

She asked about my trip. She was impressed and relieved that I managed on my own whilst I was away. It feels so long ago now, I didn’t really know what to say, other than that I coped, enjoyed most of it, but found it really exhausting.  I could have told her more, but didn’t see the point. There was limited time and plenty of other things to cover.

We talked about things with the bloke. Before I went away, things between us had been somewhat up in the air. When I last saw Dr M, there was a very real chance that we would split up. I haven’t written about this here before now, because I don’t think the bloke would be overly comfortable about me sharing this with the world.

The whole idea of the trip to Europe, was to give us some time apart to reassess things. I was going to just take a “boring” holiday somewhere, but options are limited for solo travellers and I’d always wanted to go InterRailing, so I decided to give it a go. It also seemed like a great chance to test myself to see if I could be more independent and to cope on my own.

I’d talked about all of this at my last appointment and Dr M was keen to know what has happened since then. Things between us have settled down and pretty much gone back to how they were before things became difficult. It’s almost as if nothing had happened. Neither me, nor Dr M could decide if this was a good thing or not. On the whole, it is probably good. Things were not good at all when I left and it is nice to know that he missed me a lot, but it has also been a little disappointing. When I got back, we talked a bit about what had happened and how we should try to improve things and appreciate each other more. Unfortunately, it doesn’t feel like anything has changed or improved.

We talked about my trip to Occy Health. I explained what he said about not starting a proper scheduled return yet, but how we tried to think about the ways we can solve some of the problems that are stopping me from getting back to work. I told her that he’d said I could try to visit the office and that I managed to go to a meeting last week for a couple of hours, which she was impressed by. It was a really big step, so that’s good. However, she seemed disappointed that there was nothing further planned yet. I suggested that I will probably try to go in again in the next week or so, but I hadn’t decided when yet. She wanted me to try to commit to a time and hoped that I could start to go in on a more regular basis, even if it is only once a week for a few weeks. She thinks that a routine and commitment to going to work on a specific day, would help me prepare for it better. I said that is actually what I’d hoped for, but that Dr Occy Health wasn’t sure and she seemed to accept this, but she thought it would probably be okay if I chose to do it, rather than having my work-place imposing it on me. She may be right and I was considering this myself. I will try and decide when would be best.

We did talk about my mood and how it has recently dropped quite a bit. I don’t think she was too concerned or especially surprised, although she was possibly a little disappointed. She asked about the usual stuff . Sleep, suicide, anxiety… She was not surprised to hear of my nightmares or generally rubbish sleep (occasionally too much or usually too little and never feeling rested). I had to admit that suicidal thoughts had returned, although they were a lot less frequent and different to how they were a year ago. She hadn’t actually realised that the thoughts had pretty much gone away over the summer, which was a surprise. I’m sure I’d told her last time that I wasn’t really suicidal any more and that I no longer felt that life was completely hopeless. Although I can feel pretty awful at the moment, I have got my hope back that I can be well again. A year ago, I could never imagine a life without feeling horrifically depressed, so it was no wonder I could see no future and wanted to end it. I do get frustrated at the fact that I have got worse again. I wonder if I will always be waiting for the next relapse and if so, is it worth it? I am able to cope with these thoughts at the moment, as I still have some hope of a recovery.

We talked about the risk that I may do something impulsive if I have a particularly bad day. I told her there was no immediate risk of me killing myself and that I have no intention to make any detailed long-term suicide plans like I have in the past, but that I couldn’t guarantee that I wouldn’t just do something on impulse. I don’t tend to be impulsive and have never made the decision that way in the past, but if an opportunity presented itself, there are times when I can be very tempted to take it. She recognised this and I guess she knows that there is always a greater risk of completed suicide when people are either recovering or deteriorating. When you are really, seriously depressed, it is far too much effort to kill yourself, but when you’re having a bad day after a series of not-so-bad days it can seem a lot worse and you are also more likely to have the energy and drive to do something about it.

I mentioned that I felt that the arrival of autumn did not seem to be helping and she agreed that there was probably a seasonal element. She had noticed back in the spring that things seemed to improve a lot faster for me when the weather picked up in April, so it is natural, I guess, that things would get worse again when the summer ended.

We talked about my medication and she agreed that it probably needs a tweak, if only to help me get through winter. Her first instinct was to add Quetiapine. Apparently, it was licensed the other day in the EU as an augmentation treatment for Major Depressive Disorder, although she admitted that most psychiatrists had been using that way for a while anyway. She asked if I’d been on it before and I confirmed that I had. I was taking it along with Venlafaxine, back in February 2009 when I overdosed on it. She asked what doses I’d been on and I said I couldn’t remember but I did get right up to 550mg. She said that for MDD they use a max dose of 300mg, but I had been on that sort of a dose for a while too, so I’m not sure it would help. I also mentioned that it never seemed to help with insomnia and that I had put on weight last time. She said she didn’t expect it to help the insomnia and she seemed genuinely surprised about the weight. Although it didn’t help me with insomnia, I know plenty of people who find it knocks them out, so that seems a little strange. There are also plenty of people that have found it made them put on weight too, so I am not alone. Both drowsiness and weight gain are listed in the common side effects, so you would have thought she was aware of that. Anyway, I said no to Quetiapine.

The other options were to do nothing, increase the Reboxetine, swap the Reboxetine or try to add something else. I wasn’t sure doing nothing was a good idea and we both agreed that stopping the Reboxetine was a really stupid idea, as it is the first AD that has ever helped me. Reboxetine has shown that Noradrenaline is probably the key to my wonky brain chemicals and there aren’t many others that help on that front, so we’re not sure what else to do. She didn’t have any bright ideas of anything else to try really. If not quetiapine, then she said we’d probably be looking at augmenting with Lithium or another anti-depressant, but she wasn’t sure what would be best. She said she would have a look for some ideas though before I next see her and she was welcome to any suggestions I may have – so if anyone has any ideas, let me know. I’ve been on most of the common combinations already and my only real thought is perhaps bupropion, but it’s not licensed as an AD here (although it is used an awful lot in the US), so I don’t know if she’d give it a go. I know a couple of people who have found it helpful though, so it may be worth a try.

In the end, we decided that increasing the Reboxetine was probably the best option for now, although I am worried about how I will be with the side-effects. It is worth a go though and if it is too much then we will have to try something else. I hope it helps, without making me feel too awful. She said she’d get a letter sent to Dr N. I have plenty left at the moment anyway, so will just increase the dose myself for now. It only comes in 4mg tablets anyway, so it makes little difference. So yes. I am now going to be taking 8mg of Reboxetine. I didn’t actually tell her that I’ve occasionally taken 8mg anyway, when I’ve not been able to cut one of the tablets in half to make the 6mg. One day doesn’t make much difference though, but 8mg over a week probably will. We will see anyway.

After that, I remembered that I had also been for the therapy assessment. I told her what had happened and that I will probably be waiting for someone to come back from maternity leave. She named the person she thought it would be. We shall see what happens anyway. She isn’t impressed that I’ve been waiting over a year and was shaking her head saying “it’s probably only going to get worse, only going to get worse…” as she looked at her diary to book our next appointment. It really isn’t good.

Anyway, time was up then and I had to go. I see her again in 6 weeks, so we shall see how we go with the Reboxetine.