Into the system…

blogging, work, mental health, therapy, disability, benefits and more…

Too much to say…

with 12 comments

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.

12 Responses

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  1. Hey. I identify with a lot of this. I am starting therapy a week Monday, whoop. Ouch, PD diagnonsense is an issue for me too currently (am being threatened with it) and I too think my actual condition is bipolar. Similarly, I haven’t exactly been behaving as I normally do, due to the trauma of being dismissed from my job, which worsened my existing mood disorder, and I did something stupid (don’t want to trigger anyone so won’t go into it). Yes I am more difficult to deal with, it’s because I’m suffering, but the CMHT think I am a manipulative, demanding twat. (I managed to write a document for them which was supposed to explain why I suspected bipolar 2, but was written when drunk and on an agitated-depressive self-critiism thing, so neglected to mention certain vital symptoms while basically portraying myself as a horrible person. Clever, I am). Whew, that was ‘me me me’. I’m glad your therapy seems to be starting well, and hope it helps you.
    I wouldn’t pressure yourself to increase your hours at work – you didn’t ‘fail’, or let anyone down, OK? It just takes some time sometimes. You’re just starting therapy and from the sound of it your meds aren’t quite right – physical side effects will sap your energy too. Sorry to be blunt but I don’t think an approach of ‘setting targets’ is all that helpful, it’s just going to make you feel bad, as you are, if you don’t make them. Mental illness isn’t really all that predictable anyway, hon.

    Butterflywings

    Friday, 4th February 2011 at 5:27 pm

    • Good luck with your therapy.

      I don’t know what my condition is – bipolar or recurrent depression or what, but I do believe it is a mood disorder as opposed to a personality one.

      Hmm, I guess it is me describing them as targets rather than occupational health. They were meant to be ceiling limits – I am not allowed to increase beyond that number of hours, but I am to take the increase up to that limit as slow or fast as I like really. The problem is I don’t know what is best. Sometimes I think it would be better to do lots more hours but other days, just three hours seems like an impossibility and a real struggle. My mood is so up and down I don’t know what to do. When I feel okay, it seems like I am being held back because although I was told by OH I could go up to 12 hours, HR were still reluctant to let me increase. When I’m feeling crap, I’m glad of the hesitation.

      It seems Rehab Consultant Woman has been itchy to get me to increase my hours anyway. She’s given HR a plan to increase my hours by half an hour each day, per week over the next few weeks. e.g. Do 3.5hrs x 2 next week, 4hrs x 2 the week after etc. Not sure how that will go, but it’s worth a try and at least HR can’t hold me back.

      Thanks for the comment. x

      intothesystem

      Saturday, 5th February 2011 at 4:27 pm

  2. You seem to have had a busy few weeks. I hope the therapy works out for you. Seems the assessment is going okay so far. As for your medication, I agree you shouldn’t be changing right now that you’re starting therapy, because if you’re feeling better (or worse) you wouldn’t know why. If you can mange until the spring, that is a very good thing. I’m sorry you’re a little unstable still, and hope you get better soon.

    Astrid

    Friday, 4th February 2011 at 9:06 pm

    • Thanks Astrid.

      I hope I can get through until spring, but I’m finding the instability the hardest thing to cope with at the moment. Not so much the crappy depressed days, but the agitated ones and the all over the place ones. I don’t know where I stand at all. It makes it hard for me to know how I’m managing with work and everything. One minute I feel fine, the next, I’m floundering. It’s driving me mad. I’d been so boringly stable and just consistently a bit low for so long and then all of sudden for no apparent reason my mood has gone haywire.

      Oh well. I am managing to keep my head above water. I just worry my legs are getting tired!

      Thanks for commenting. x

      intothesystem

      Saturday, 5th February 2011 at 4:32 pm

  3. I am glad to see a post from you and pleased to read that you are finally having the assessment for the therapy, it seems to have taken ever to get to this point for you. I can relate to the whole not reading other blogs, I have pretty much stopped commenting and reading a lot simply because it takes up to much time, I feel guilty about this as I have made so many friends in the blog world but I have decided I need a little me time and the less time I spend online the better.

    Keeping plodding on, I often keep you in my thoughts x

    Ms Leftie

    Monday, 7th February 2011 at 7:11 pm

    • Yeah, I’m trying to cut down my online time, although I just seem to end up doing other stuff instead.

      It’s been well over 18 months since I was first referred for therapy with the NHS. It’s ridiculous really. So much has changed and happened since then.

      intothesystem

      Wednesday, 16th February 2011 at 5:32 pm

  4. Hi. Yeah increasing by half an hour a day sounds like a good plan.
    I know exactly what you mean about being up and down. I think the thing is to do a bit *less* than you think you can on up days, and a bit *more* on down ones, but ha, if you manage that, please tell me how. Sorry, I thought you’d said you thought you had bipolar before, but my brain is mush sometimes. I am also unsure, I am certain I have some kind of mood disorder rather than a personality one. I do *think* it is mild bipolar, but I wouldn’t place bets on it. It can be difficult to tell unipolar depression from bipolar. Specifically, energised/ agitated depressions from hypomania. I can really identify with the instability being the hardest thing. I’d take being stable but a bit low. I am that way now and I feel like myself. I used to be, mostly, that way for a long time, and I’d only occasionally get either very low or agitated/ hypomanic, but bloody Venlafaxine had me all over the place, as you describe, I’d be fine one minute, euphoric the next, ragingly angry the next, then crying…of course we’d take being a little low over that.
    I hope things stsbilise for you, and that therapy works out x

    Butterflywings

    Wednesday, 9th February 2011 at 4:37 am

    • hehe I am not sure I’ll ever get the balance for doing stuff right. Then again I’m not sure that’s the problem. Down days don’t always follow up ones if you know what I mean. There seems to be no pattern to it at all!

      Just about managing with the extra half hours, but it’s hard work. I think I’d be better off not doing it! Oh well.

      I used to have a Bipolar II diagnosis, but when I was admitted in Jan 2010 they challenged that and said they thought it was recurrent depressive disorder and a personality disorder. So I don’t know!

      I was stable but a bit low for a while too. Definitely better than all over the place!

      x

      intothesystem

      Wednesday, 16th February 2011 at 5:39 pm

  5. Hi, I do hope you don’t mind me commenting, I have read your blog for a while now and find it incredibly interesting. You remind me an awful lot of myself and the way you write is exactly how I wish I could convey my feelings. I am writing as I can understand how disjointed the therapy may seem at the moment – I am very lucky to live in a Trust where Mental Health is funded very well and as a result I have been having therapy for one year. When I first began it, it took me a while to accept a therapist’s way of working, each session seemed not necessarily to flow from the previous and I, like you, tended to not be able to focus on what was said after the session had ended! I am here with good news, eventually as your sessions continue things will fall into place without you even realising, then one session you will see the flicker of light and realise that all of the struggle at the start has bought you to the beginning of a journey to get better :) I hope that makes sense, please perservere and fight for the chance to continue with the therapy..it really is a life saver :)

    Take care, and again I hope you dont mind me commemting.

    Jo

    Thursday, 10th February 2011 at 4:29 pm

    • Thanks. Of course I don’t mind you commenting. Funnily I’ve seen your employer’s IP address come up in the stats and always wondered who it could be that lurks, but doesn’t comment!

      It’s good to know that somewhere NHS services do work. I am glad your therapy has helped. I hope mine will get a little less confusing soon!

      intothesystem

      Thursday, 10th February 2011 at 5:29 pm

  6. I’ve been rumbled!! I will be happy to post, thank you :) x

    Jo

    Wednesday, 16th February 2011 at 1:08 pm

    • Thanks. It’s good to know there are people out there reading that appreciate it. x

      intothesystem

      Wednesday, 16th February 2011 at 5:33 pm


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