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	<title>Into the system...</title>
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	<description>blogging, work, mental health, bipolar disorder, therapy, benefits and more...</description>
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		<title>Into the system...</title>
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		<title>Backlash&#8230;</title>
		<link>http://intothesystem.wordpress.com/2009/12/30/backlash/</link>
		<comments>http://intothesystem.wordpress.com/2009/12/30/backlash/#comments</comments>
		<pubDate>Wed, 30 Dec 2009 12:15:07 +0000</pubDate>
		<dc:creator>intothesystem</dc:creator>
				<category><![CDATA[Into the system...]]></category>
		<category><![CDATA[arguments]]></category>
		<category><![CDATA[backlash]]></category>
		<category><![CDATA[blogging]]></category>
		<category><![CDATA[bloke]]></category>
		<category><![CDATA[child]]></category>
		<category><![CDATA[faking]]></category>
		<category><![CDATA[friends]]></category>
		<category><![CDATA[frustration]]></category>
		<category><![CDATA[guilt]]></category>
		<category><![CDATA[internet]]></category>
		<category><![CDATA[medication]]></category>
		<category><![CDATA[mental illness]]></category>
		<category><![CDATA[partner]]></category>
		<category><![CDATA[teenage fantasy]]></category>
		<category><![CDATA[twitter]]></category>
		<category><![CDATA[writing]]></category>

		<guid isPermaLink="false">http://intothesystem.wordpress.com/?p=421</guid>
		<description><![CDATA[It has been a long time since I last posted. I&#8217;ve been popping onto twitter to write a few 140 character updates, but that&#8217;s all I&#8217;ve had time for. I think the amount of woe on there will suggest how things have been though.
Sadly there was plenty of backlash from the confession about my meds. [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=intothesystem.wordpress.com&blog=3960408&post=421&subd=intothesystem&ref=&feed=1" />]]></description>
			<content:encoded><![CDATA[<div class='snap_preview'><br /><p>It has been a long time since I last posted. I&#8217;ve been popping onto twitter to write a few 140 character updates, but that&#8217;s all I&#8217;ve had time for. I think the amount of woe on there will suggest how things have been though.</p>
<p>Sadly there was plenty of backlash from the <a title="confession" href="http://intothesystem.wordpress.com/2009/12/19/face-the-music/">confession about my meds</a>. I had feared it, but hoped it wouldn&#8217;t materialise. My bloke was upset. As is often the case when he&#8217;s angry, he ignored me and wouldn&#8217;t speak to me for a while and then he had a go at me. I know it is understandable that he was upset, but I get fed up of the same argument.</p>
<p>Apparently I don&#8217;t want to get better and my illness is all some &#8220;stupid teenage fantasy&#8221;. It seems I want to think that I&#8217;m ill so that I fit in with all my &#8220;whiny teenage girl internet friends&#8221;. He thinks that we all encourage each other to get worse and that we all want to be part of some stupid mental club. Basically, the argument always boils down to the same thing. Blogging is evil and that everyone that does so is a whiny, faking moron.</p>
<p>As you can imagine, this doesn&#8217;t exactly go down well. I try to argue back, but it&#8217;s pointless. I can say that I don&#8217;t choose this illness. I can say that I am definitely not trying to fit in, but that I appreciate knowing I&#8217;m not the only one going through this and the support helps. I can also say that not everyone who blogs is a teenager or a girl and that not every blog I read is about mental illness, but it makes no difference. His mind is set and he will never be happy about my blog.</p>
<p>As well as the argument, he tried to stop me coming on here for a while. He also banned me from meeting  up with <a title="Em" href="http://eccedentesiat.wordpress.com/">Em</a> and <a title="Kate" href="http://blueskiesandgreengrass.wordpress.com/">Kate</a>. We&#8217;d arranged to meet up when I had my appointment with DP before Christmas. Instead my bloke took the afternoon off work and drove me to and from the appointment so I couldn&#8217;t see them. I hate that he treats me like a child.</p>
<p>I find this so hard. I don&#8217;t know what I would do without this space and without the support of my readers, but I am fed up of the arguments. He makes it uncomfortable every time I try and come on here. He moans at me every time I open my laptop. He refers to twitter as &#8220;twatting&#8221;. He belittles the whole thing and doesn&#8217;t see or care how much it hurts me. I have always found the internet a great source of support and he seems hell bent on ruining that.</p>
<p>I&#8217;m not sure posting this is a good idea. It will probably only add fuel to the fire, especially so long after the event, but I&#8217;m still feeling the consequences. I feel guilty whenever I come on here. I feel like a naughty girl defying her parents, and it shouldn&#8217;t be like that. I wish it wasn&#8217;t.</p>
<p>I have other things to post about. My last appointment with DP, Christmas, the end of the year/decade&#8230; but I don&#8217;t suppose I&#8217;ll get much chance this week.</p>
<p>To illustrate the point, he just came over, looked at my laptop and saw I was writing. Then said &#8220;for crying out loud&#8221; and walked off. Just these little digs all the time are making it all harder.</p>
<p>*sigh*</p>
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		<title>This Week&#8230;</title>
		<link>http://intothesystem.wordpress.com/2009/12/19/this-week/</link>
		<comments>http://intothesystem.wordpress.com/2009/12/19/this-week/#comments</comments>
		<pubDate>Sat, 19 Dec 2009 21:26:17 +0000</pubDate>
		<dc:creator>intothesystem</dc:creator>
				<category><![CDATA[Into the system...]]></category>
		<category><![CDATA[AGM]]></category>
		<category><![CDATA[anxiety]]></category>
		<category><![CDATA[christmas]]></category>
		<category><![CDATA[creative remedies]]></category>
		<category><![CDATA[Crufts]]></category>
		<category><![CDATA[dog show]]></category>
		<category><![CDATA[DP]]></category>
		<category><![CDATA[Dr N]]></category>
		<category><![CDATA[fundraising]]></category>
		<category><![CDATA[J]]></category>
		<category><![CDATA[mood]]></category>
		<category><![CDATA[pride]]></category>
		<category><![CDATA[therapy]]></category>
		<category><![CDATA[Useless Social Worker]]></category>
		<category><![CDATA[week]]></category>

		<guid isPermaLink="false">http://intothesystem.wordpress.com/?p=416</guid>
		<description><![CDATA[I can&#8217;t remember half of what has happened lately.
Last Saturday was the village Christmas festival, so I spent the day selling tea and cake in the village hall. We raised over £300 for charity, but it was bloody hard work. I wasn&#8217;t in the mood to plaster on a smile and I just wanted to [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=intothesystem.wordpress.com&blog=3960408&post=416&subd=intothesystem&ref=&feed=1" />]]></description>
			<content:encoded><![CDATA[<div class='snap_preview'><br /><p>I can&#8217;t remember half of what has happened lately.</p>
<p>Last Saturday was the village Christmas festival, so I spent the day selling tea and cake in the village hall. We raised over £300 for charity, but it was bloody hard work. I wasn&#8217;t in the mood to plaster on a smile and I just wanted to run away and hide. We got there though.</p>
<p>Sunday was the dog show in Birmingham. It was a very long day. Getting up at 6am and sitting around with very little to do for hours on end was tough. Our dog won the best puppy bitch, best junior bitch and best puppy in breed though, which means she has qualified for Crufts. It&#8217;s a rare breed so there isn&#8217;t much competition, but she beat her litter-mate sister. Considering her sister is owned by the breeder and they know what they are doing we were pretty impressed . We&#8217;d never even been in the ring before, so to win was a little surprising. So yes despite feeling awful most of the day, I did manage to get a bit of enjoyment out of the day. I definitely felt proud.</p>
<p>On Monday we had the Creative Remedies AGM. The day didn&#8217;t start well when I burst into tears on the bus. Forgot it was before half nine (by a couple of minutes!) so I couldn&#8217;t get on free with my pass and I didn&#8217;t have enough money. Was so stressed out I just burst into tears and basically had a mini panic attack. Got there in the end and the meeting was a bit flat and weird really. I was going to stand for Chair, but C wanted that role so I decided to just let her go ahead and stood for secretary instead. I saw little point in standing against her when we needed someone in the other roles anyway. I ended up getting elected to Vice Chair and Secretary in the end as we were short of people. I just hope the secretary role isn&#8217;t too stressful. We still don&#8217;t have a treasurer, which is a pain.</p>
<p>Tuesday was a slow, low, long day. In the evening we had the Ladies Circle Christmas drinks. I felt a little out of it at times, but it was nice to see some of the girls. I left early though as I was just too tired.</p>
<p>Wednesday started with a trip to see Dr N. DP had been keen for me to see him before my next appointment and I was running out of meds, but I didn&#8217;t really know what to say. Dr N knows things aren&#8217;t great right now, but I&#8217;m not sure he is fully aware of the extent of my mood. He doesn&#8217;t really know what else to do anymore though, so he just listens to me babble. I appreciate that he listens. I didn&#8217;t really babble the things I wanted to. I left feeling a bit disappointed and demoralised. I&#8217;ve made an appointment for in between Christmas and New Year though. It&#8217;s bound to be pretty booked up then so thought I better not leave it.</p>
<p>After the Creative Remedies Christmas Meal (fine, not overly exciting) it was time for the journey over to Manchester to meet DP. I had plenty of time so got a quick wander around Piccadilly Gardens before jumping on the bus to the therapy centre. The bus was packed and my bag got bashed against one of the seats. It made a loud noise, but I didn&#8217;t think much of it at the time. Later on as I was leaving therapy I realised my bag was wet and the can of Vimto I had with me had burst. I was not very impressed. The smallest thing stresses me out at the moment and I just wanted to cry.</p>
<p>Anyway, the therapy session itself? DP asked if he could send over a form from the EAP to my GP. We weren&#8217;t sure it was worth it as I am already in services, but we thought maybe Dr N can wave this piece of paper to say &#8220;look, she needs more help&#8221;. It&#8217;s worth a try anyway, so we filled that in. Then we talked about how he could help. I still don&#8217;t really know what use the four sessions are going to be (just two left now!). He wants to help me access further services, which makes sense and he wants to give me some support whilst I&#8217;m sat in the eternal wait for the NHS. I just wish it could be more.</p>
<p>I can&#8217;t really remember what we talked about though. Towards the end I got stuck and didn&#8217;t know what else to say. We just ignored each other and sat in silence for a few minutes, but it was time to wrap up anyway. I see him again next week, just in time for Christmas.</p>
<p>Thursday was a slow day again. I got up late and had slept okay. I just felt weighed down and lethargic. Truly a classic depression day. In the evening I was going to a gig in Manc and staying over with a uni friend. I didn&#8217;t really feel up to it but I made it and was glad I went. It was good to just let go, dance and pretend everything is okay. I felt a bit weird at times during the gig. Kept going dizzy and losing my balance, but nevermind. Everyone was dancing anyway so I doubt anyone really noticed. Afterwards we shuffled home in the ice and the snow trying not to fall over.</p>
<p>I didn&#8217;t sleep all night. It was cold, the air bed was sliding all over the laminate flooring and my mind was racing. I ended up just staring out the window at the icy city. It was a long night.</p>
<p>Yesterday involved another Creative Remedies meeting. We&#8217;re trying to apply for funding as we&#8217;re only funded up until March, but I noticed at the last minute that we wouldn&#8217;t have been eligible for the scheme we were about the apply to. In the end we used the hour to look for alternatives and have found a scheme that looks promising. Need to get the forms filled out in the New Year. After we tried to do a bit of Christmas shopping, but drew blanks. meh.</p>
<p>In the evening useless social worker, J called. I&#8217;d guessed what she was going to ask before she did. She wanted to know how I was. I told her I was a little better than I&#8217;d been the day before, which was true, but hardly gave her any indication to my mood. She took that to mean I was fine. She wanted to cancel our appointment for Monday, meaning I won&#8217;t see her now until January 6th. I&#8217;m quite glad I won&#8217;t have to see her for ages. Our appointments are always a complete waste of time and I usually end up wanting to hit her (please note, I won&#8217;t!). Yet I am not sure it&#8217;s a good idea either. I don&#8217;t know why I told her I&#8217;m fine. I am meant to be trying to get more help and instead I&#8217;ve let her walk away. I&#8217;m not sure Dr N or DP will be too happy I&#8217;m being allowed to slip under the radar. Nevermind.</p>
<p>So today. I&#8217;ve not done much really. Hid away from the cold a lot of the time. Wish I could just hide away from life too.</p>
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		<title>Face the Music&#8230;</title>
		<link>http://intothesystem.wordpress.com/2009/12/19/face-the-music/</link>
		<comments>http://intothesystem.wordpress.com/2009/12/19/face-the-music/#comments</comments>
		<pubDate>Sat, 19 Dec 2009 15:56:10 +0000</pubDate>
		<dc:creator>intothesystem</dc:creator>
				<category><![CDATA[Into the system...]]></category>
		<category><![CDATA[bipolar disorder]]></category>
		<category><![CDATA[compliance]]></category>
		<category><![CDATA[depression]]></category>
		<category><![CDATA[Dr D]]></category>
		<category><![CDATA[Dr N]]></category>
		<category><![CDATA[honesty]]></category>
		<category><![CDATA[hospital]]></category>
		<category><![CDATA[J]]></category>
		<category><![CDATA[Lamotrigine]]></category>
		<category><![CDATA[lying]]></category>
		<category><![CDATA[madness]]></category>
		<category><![CDATA[medication]]></category>
		<category><![CDATA[meds]]></category>
		<category><![CDATA[Melatonin]]></category>
		<category><![CDATA[non-compliance]]></category>
		<category><![CDATA[overdose]]></category>
		<category><![CDATA[propanolol]]></category>
		<category><![CDATA[stockpiling]]></category>
		<category><![CDATA[stopping medication]]></category>
		<category><![CDATA[suicide]]></category>
		<category><![CDATA[Useless Social Worker]]></category>
		<category><![CDATA[withdrawals]]></category>

		<guid isPermaLink="false">http://intothesystem.wordpress.com/?p=399</guid>
		<description><![CDATA[I think it&#8217;s time I admitted something. I started to write about this a couple of weeks ago, but I didn&#8217;t feel up to facing the music. I didn&#8217;t post about it at the time because I didn&#8217;t want my bloke to know, but now this is over I guess I can admit it.
I stopped [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=intothesystem.wordpress.com&blog=3960408&post=399&subd=intothesystem&ref=&feed=1" />]]></description>
			<content:encoded><![CDATA[<div class='snap_preview'><br /><p>I think it&#8217;s time I admitted something. I started to write about this a couple of weeks ago, but I didn&#8217;t feel up to facing the music. I didn&#8217;t post about it at the time because I didn&#8217;t want my bloke to know, but now this is over I guess I can admit it.</p>
<p><strong>I stopped taking my meds.<br />
</strong></p>
<p>I know it was stupid, but I did it anyway. I don&#8217;t know why I stopped. It started when I missed a couple of doses by accident sometime in November. I really didn&#8217;t notice any difference and started to wonder what would happen if I stopped taking my medication. It is something that has crossed my mind plenty of times, but I&#8217;d never really done anything to test it. I know my partner often questions the point of the medication and I often doubt it too. After all, I managed without it during my teens, even when I was unwell.</p>
<p>Anyway. I started forgetting to take my meds or messing with the dose. One day I&#8217;d miss the night-time dose. The next I&#8217;d skip the morning one or I&#8217;d try doubling something or whatever. I wasn&#8217;t taking any of it regularly and I wasn&#8217;t taking what I should have been.</p>
<p>This continued until I saw Dr N about a month ago. We were discussing increasing the Propanolol and he asked me something about my medication and it just slipped out that I&#8217;d been skipping doses. I don&#8217;t quite know how I ended up telling him really. I had made a concious effort to keep this a secret, but somehow it just slipped out. He gave me a mini-lecture and seemed concerned, but it was okay. He seemed to understand why I was doing it. He asked me if I&#8217;d tell Dr D and although I was very reluctant to do this, I did at our appointment last month. Dr D had little of value to say on the matter and just told me repeatedly to take my medication. This made me less keen on the idea! I don&#8217;t exactly have much faith in the man.</p>
<p>After I saw Dr N I did make an effort to start taking my medication again. I had been taking the Propanolol properly, hoping that it would help the headaches and generally I&#8217;d been taking the others too, but then the next thing I realised I&#8217;d stopped the Lamotrigine and Melatonin completely. I don&#8217;t even know when it happened. I just realised I hadn&#8217;t been taking any when I noticed I hadn&#8217;t used any of my new lot of medication. When I realised I had stopped I didn&#8217;t want to start again. I was worried about side effects and decided it was easier just to stay off them and I just didn&#8217;t care enough to bother.</p>
<p>Useless Social Worker, J asked me if I&#8217;d started taking my meds properly again and I outright lied to her. I seem to be making a habit of lying to her now. I feel bad about it, but I just don&#8217;t trust her. She asks me how I am and I tell her I&#8217;m fine. It just seems easier.</p>
<p>Then I returned to see Dr N a fortnight or so ago and he of course asked me about the meds. I couldn&#8217;t lie to him as much as I wanted to. He could see right through me anyway so I just admitted it. Again he was good about it. Concerned, but understanding. He even went as far as to say he&#8217;d probably think the same if he was taking regular medication and didn&#8217;t see much benefit to them. Unprofessional perhaps, but he knows me pretty well and I think his attitude is that any intelligent person would question such things.</p>
<p>He did point out though that I was less well than I had been a couple of months before and that I was heading the right way towards admission. He joked that he knew if I needed to be admitted again, it would take the men in white coats to do it. He is right of course. Voluntary admission to Hollins Park is just not happening. I&#8217;d consider somewhere else, but I&#8217;m not going back there if I can help it. I&#8217;ve actually been bad enough to consider that hospital may be the best place for me right now, but I&#8217;m not going to rush there in a hurry.</p>
<p>He asked me if I was throwing the pills away or stockpiling and I had to admit I&#8217;d been stockpiling. He was concerned that I was planning an overdose, which I guess was a logical assumption. I hadn&#8217;t been really though, knowing that Lamotrigine even in those doses is unlikely to cause much damage. Not to say that I hadn&#8217;t considered doing it anyway just in case.</p>
<p>He tried to persuade me to take the medication again. We agreed that I would need to titrate the dose back up, but we should do it quickly, unlike the usual 25mg increases used for Lamotrigine. So he didn&#8217;t give me another script for the Lamotrigine and sent me on my way with one for the propanolol &#8211; which I had still been taking intermittently. I was told to come back when I had used up most of my stock or if I needed to before.</p>
<p>So I reluctantly restarted the meds. My thoughts were confused on the matter. I didn&#8217;t want to because I didn&#8217;t see the point. In another way I wanted to because maybe restarting the meds so quickly would go horribly wrong and kill me anyway (there is meant to be an increased risk of <a href="http://en.wikipedia.org/wiki/Stevens%E2%80%93Johnson_syndrome">The Rash)</a>. I also wondered if I continued to get worse whilst back on the medication then maybe people will not blame any deterioration on that and I will prove my theory right that the medication is crap. I guess the rational part of me also hoped that things would actually improve again.</p>
<p>I saw Dr N again this week. I told him I&#8217;d restarted the medication and he seemed pretty relieved. He said he had been quite doubtful if I would, which is fair enough. I doubted if I would. I think he was pretty worried about what might happen if I didn&#8217;t though and I suspect he questioned whether or not he should have been getting the crisis team involved, with a view to calling the men in white coats. I found it hard to talk to him this week though. I didn&#8217;t know what to say and was a little vague. I should have been more honest about how things are, but I fear those white coats. I was at the branch surgery too and I always feel uneasy there. I think it&#8217;s because it brings back memories of the silly overdose back in September 2008.</p>
<p>He asked if restarting the Lamotrigine was making me sleepy, which was possibly his way of telling me that I didn&#8217;t seem with it. I wasn&#8217;t really with it, but I didn&#8217;t know what to say. I didn&#8217;t think it had been. If anything it had increased the insomnia, but then again I may be more tired in the day due to sleep deprivation. I had little to report in the way of side effects, but I&#8217;m not sure I&#8217;d even notice any if they were there.</p>
<p>So how have I been without the medication? Did my experiment teach me anything? Yes, I have to admit I&#8217;ve not been well this last month, but is it due to a lack of medication? I know that everyone is going to blame my deterioration on the lack of meds, but I really don&#8217;t think it&#8217;s that simple. I think the fact I stopped taking the pills is probably symptomatic of the deterioration. When I stopped, things were already messy. I was very suicidal. I wasn&#8217;t thinking clearly. I was having weird dissociative episodes and felt out of control. I was getting worse anyway and because of that I didn&#8217;t care what happened to me. Stopping the medication seemed like a logical step.</p>
<p>I think about why I did it and I don&#8217;t really have any answers. My thoughts were racing through all sorts of things at the time. I guess maybe I just wanted to accelerate the self-destruction. I think I almost hoped that I&#8217;d go truly mad and finally have the impetus to try and off myself again. I&#8217;ve been holding on by a thread for so long I just wanted to snap it. I seem to spend so much time depressed lately, that I wondered if it is the medication causing it. In some ways the monotonous, not-quite-so-bad depression is worse than the actual pits of despair. It&#8217;s so dull and draining. I was truly fed up of it. I had been a little better, but I still wasn&#8217;t well and the knowledge of that was demoralising. If the best I can hope for is moderate-severe depression then I&#8217;m screwed. Life really isn&#8217;t worth it. I am perpetually suicidal and even the improvement I saw a couple of months ago was not enough to change that. I wanted out and this seemed a way to do it. I knew there were risks involved with stopping the meds and I wanted to take them. I felt awful anyway, so what was the point in the medication?</p>
<p>Part of me also wanted to see if I could induce some hypomania by stopping my medication. I&#8217;ve wondered a lot recently about what would happen if I was unmedicated. Would my little ventures upwards continue to escalate without the medication pulling me down? I want to experience the highs as well as the lows. What is the point in living with this awful mood disorder if I only get the horrible side of it. The depression and agitated mixed states, but none of the &#8220;nice&#8221; highs. I just wanted a change and hoped that by stopping my medication I&#8217;d be able to create that.</p>
<p>All the while I did have a small piece of rational mind that questioned what I was doing. I could feel I was getting more out of control, but this rational side was not strong enough to stop the rest of my mind. I think it was also overpowered by a little part of me that hoped this would be enough to make people realise I was struggling. Maybe it would help me to get more support. Perhaps it was really a pathetic cry for help?</p>
<p>Another theory is it was actually a way of stopping me from killing myself. By doing this I was trying to change things. I was trying to prove my medication wasn&#8217;t right. I was also trying to see if I could make things better without the medication. I needed a change. I couldn&#8217;t carry on the way things were. I was getting impatient again and the way things were going I&#8217;d have tried to kill myself out of frustration pretty soon anyway, just as I did when I was in a similar place at the start of the year. I&#8217;m annoyed that I didn&#8217;t spot the loop repeating itself, but maybe I did and this was my way of changing the course.</p>
<p>I also worry about what people think of me for this. I knew it was such a cliché to stop taking my medication and I hated being that cliché. I worry that people will think I don&#8217;t want to get well and that my illness is all my fault and that I&#8217;m just not trying hard enough. I worry about having non-compliance all over my notes.</p>
<p>Sadly my foray into non-compliance hasn&#8217;t really worked out as I had hoped. The lack of meds didn&#8217;t trigger any really nasty side effects. I didn&#8217;t get fits, like the patient information leaflet warns. I certainly didn&#8217;t get any highs. I just continued the way I was already going, getting more and more suicidal and losing motivation and energy all the time. I didn&#8217;t manage to kill myself, possibly because I am too depressed and can&#8217;t be arsed. I continued to pretend everything was fine and hid this from almost everyone.</p>
<p>I wonder what would have happened though if I Dr N hadn&#8217;t got this out of me so soon. If I&#8217;d stayed off the meds longer maybe what I&#8217;d secretly hoped might happen would have. I wish I had the chance to find out. I still don&#8217;t want to take the medication. I still see very little point. I noticed that I slept better without the Lamotrigine and with it my sleep has got worse again. I&#8217;ve felt a bit physically dodgy since restarting, which is a pain, but nothing overly nasty. I didn&#8217;t seem to get any withdrawals coming off the meds either. I don&#8217;t feel any better now than I was when I didn&#8217;t take them, so maybe things would have been the same with or without. It maybe feels like someone is trying to put the brakes on my snowballing descent though. I feel a little more in control, but then again, brakes don&#8217;t work in ice and I am not sure they are working right now.</p>
<p>Maybe a little longer and things will stabilise. Medication can take a while to kick in. Dr N suggested we increase the Lamotrigine after Christmas if things aren&#8217;t any better. I wonder if it&#8217;s worth trying something new instead. Yes, maybe this test has proved the medication does help a tiny bit. Yes, it is by far the best medication I&#8217;ve been on so far, but I am not sure it&#8217;s enough. If all the medication can manage is to keep my head above water, then what is the point? If things continue as they were then this will probably only happen all over again. That or I&#8217;d try and kill myself in frustration. It&#8217;s very true that you are at more risk of killing yourself when you are getting better. I proved that back in February.</p>
<p>So.. I&#8217;ve got that off my chest now. I am worried if there will be any backlash. I hope not.</p>
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		<title>Back in time&#8230;</title>
		<link>http://intothesystem.wordpress.com/2009/12/10/back-in-time/</link>
		<comments>http://intothesystem.wordpress.com/2009/12/10/back-in-time/#comments</comments>
		<pubDate>Thu, 10 Dec 2009 22:05:57 +0000</pubDate>
		<dc:creator>intothesystem</dc:creator>
				<category><![CDATA[Into the system...]]></category>
		<category><![CDATA[CORE]]></category>
		<category><![CDATA[crisis team]]></category>
		<category><![CDATA[DP]]></category>
		<category><![CDATA[Dr N]]></category>
		<category><![CDATA[EAP]]></category>
		<category><![CDATA[EAP therapist]]></category>
		<category><![CDATA[ECT]]></category>
		<category><![CDATA[email]]></category>
		<category><![CDATA[guilt]]></category>
		<category><![CDATA[history]]></category>
		<category><![CDATA[memory]]></category>
		<category><![CDATA[NHS]]></category>
		<category><![CDATA[promises]]></category>
		<category><![CDATA[red flag]]></category>
		<category><![CDATA[risk]]></category>
		<category><![CDATA[self-harm]]></category>
		<category><![CDATA[silence]]></category>
		<category><![CDATA[suicide]]></category>
		<category><![CDATA[support]]></category>
		<category><![CDATA[therapy]]></category>
		<category><![CDATA[verbal contract]]></category>

		<guid isPermaLink="false">http://intothesystem.wordpress.com/?p=412</guid>
		<description><![CDATA[It felt very strange to see DP again yesterday. It was like going back in time.
On my way there I was trying to remember what he looked like, but all that came to mind was the fact he was bald. When I got to the therapy centre, it took me a minute or two to [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=intothesystem.wordpress.com&blog=3960408&post=412&subd=intothesystem&ref=&feed=1" />]]></description>
			<content:encoded><![CDATA[<div class='snap_preview'><br /><p>It felt very strange to see DP again yesterday. It was like going back in time.</p>
<p>On my way there I was trying to remember what he looked like, but all that came to mind was the fact he was bald. When I got to the therapy centre, it took me a minute or two to recognise the building. It kinda made me realise how fuzzy my memory is of last year. I still blame ECT.</p>
<p>Memories started to come back though. Silly things like waiting in the kitchen until he was ready, taking off your shoes (both of us without undoing them!) and the blue sofas lined up against the wall.</p>
<p>We didn&#8217;t dwell on the paperwork. CORE outcome measure form and a couple of consent forms and that was it. A pleasant contrast to last week&#8217;s 50 minute form filling marathon!</p>
<p>Then of course he turned to me and asked me to start. I knew he would sit there in silence for the full hour if necessary, so it didn&#8217;t take me long to get going. I had taken notes with me, hoping I could update him on the last 18 months quickly without having to say anything. Sadly he wanted me to talk over things myself. I kinda knew that was coming.</p>
<p>I went over the main points. Last summer, The Priory, February&#8217;s overdose, ECT, Bipolar diagnosis and since. All the stuff I&#8217;ve been over a million times now. I can&#8217;t really remember, but I don&#8217;t think he said much at this point. He never did say much. I think he was a little shocked though.</p>
<p>The conversation moved onto what use the sessions are going to be. He seemed doubtful as to whether there was any point in working together for only four sessions. I explained the theory &#8211; that it would give me a little support in the interim and help me identify areas to work on long-term, but I am not sure he agreed. I am wondering if he just doesn&#8217;t want to work with me again. I am worried that I might have scared him off. I don&#8217;t know. I feel quite paranoid about it all.</p>
<p>We talked about how things are now. He asked what the current situation was care-wise, family-wise etc. I filled in some gaps. We talked about my mood too and that being what it is at the moment we got onto the question of self-harm and suicide. I think he was a little concerned and possibly a little panicked. I do wonder if he is used to dealing with this, but then surely most people in therapy have considered such things?</p>
<p>He pointed out that my risk level means I am a &#8220;red flag&#8221; client and he will need to talk to the EAP about whether or not we should continue. I remembered this from last time. I was a red flag last year and I&#8217;m not sure there has been a time since when that status would have been lifted. I am wondering if he is using this as a way to escape me. The other EAP therapist didn&#8217;t bring it up, but nothing has changed really when it comes to risk levels. I pointed out that the EAP were aware of my situation when they took me on this time and I hope that means it won&#8217;t be a problem, but he said he still wanted to talk to them.</p>
<p>He asked me about a verbal contract too. He wanted me to give my assurance that I won&#8217;t do anything to harm myself whilst I am seeing him for therapy. A repeat of the request from the EAP counsellor really. I struggled to give it, not because I have plans to do anything, but for other reasons. I think part of the reason is not wanting the added guilt. The guilt I get from wanting to break those assurances, because the suicidal thoughts are still so strong. I feel bad for even having the thoughts. I guess my reluctance is also to do with the fact I don&#8217;t trust myself any more and don&#8217;t see the point if I can break my promise. I had given my assurance to people I wouldn&#8217;t act when I made the attempt back in February and it wasn&#8217;t enough. I have assured myself enough times that I shouldn&#8217;t act, yet it wasn&#8217;t enough in the end. There have been other times though that making a promise to someone has been enough to make me think more than twice, so maybe it is worth it.</p>
<p>Towards the end we talked about next steps.</p>
<p>He thinks I should be getting more NHS support at the moment. I think he may be right, but I wonder what support there is. What point is there in the crisis team? I&#8217;m perpetually in crisis and I don&#8217;t think it would be helpful. What point is there in contacting the CMHT or asking for a urgent psych appointment? Useless social worker, J is on holiday and Dr D didn&#8217;t know what to do with me when I saw him last month anyway. What point is there in bothering Dr N any more than I already do? He has nothing more to offer me.</p>
<p>As we finished up, DP told me to email or text if I need to, which I am grateful for. I guess the fact he offered that option shows he cares and is trying to help. He certainly didn&#8217;t have to.</p>
<p>Overall the session was hard work and quite strange, but I left feeling relieved. I think it was helpful. I don&#8217;t know though. It is hard to tell.</p>
<p>In other news, today I had a phone call from the therapist I saw last week wondering where I was. The EAP had forgotten to contact him to say I wouldn&#8217;t be seeing him again. I wish I&#8217;d cancelled myself now, but I just didn&#8217;t know what to say. I feel bad that he was waiting for me. I hope the EAP pay him for the mix-up!</p>
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		<title>EAP Therapy&#8230;</title>
		<link>http://intothesystem.wordpress.com/2009/12/08/eap-therapy/</link>
		<comments>http://intothesystem.wordpress.com/2009/12/08/eap-therapy/#comments</comments>
		<pubDate>Tue, 08 Dec 2009 15:33:30 +0000</pubDate>
		<dc:creator>intothesystem</dc:creator>
				<category><![CDATA[Into the system...]]></category>
		<category><![CDATA[bipolar disorder]]></category>
		<category><![CDATA[blogging]]></category>
		<category><![CDATA[CORE]]></category>
		<category><![CDATA[DP]]></category>
		<category><![CDATA[EAP]]></category>
		<category><![CDATA[EAP therapist]]></category>
		<category><![CDATA[mental illness]]></category>
		<category><![CDATA[risk]]></category>
		<category><![CDATA[therapist]]></category>
		<category><![CDATA[therapy]]></category>
		<category><![CDATA[trust]]></category>

		<guid isPermaLink="false">http://intothesystem.wordpress.com/?p=408</guid>
		<description><![CDATA[I&#8217;m still not able to face the draft I started the other day, but here&#8217;s hoping I can try and complete a post for once.
In my last proper post I mentioned the EAP and the fact I was being referred to a therapist nearer to here. An appointment was arranged with a therapist based in [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=intothesystem.wordpress.com&blog=3960408&post=408&subd=intothesystem&ref=&feed=1" />]]></description>
			<content:encoded><![CDATA[<div class='snap_preview'><br /><p>I&#8217;m still not able to face <a title="draft" href="http://intothesystem.wordpress.com/2009/12/03/started-a-draft/">the draft I started the other day</a>, but here&#8217;s hoping I can try and complete a post for once.</p>
<p>In my <a title="last proper post" href="http://intothesystem.wordpress.com/2009/11/24/waste-of-time/">last proper post</a> I mentioned the EAP and the fact I was being referred to a therapist nearer to here. An appointment was arranged with a therapist based in Manchester and I attended last Thursday. The appointment basically consisted of <a title="CORE" href="http://www.coreims.co.uk/">CORE</a> form filling. I knew I would have these forms to complete. I had the same forms to complete last time I used the EAP service, but I hadn&#8217;t expected them to take the whole session. I had expected the chance to at least talk a little.</p>
<p>The thing is, I don&#8217;t think I&#8217;d have talked given the chance anyway. I wasn&#8217;t comfortable with him and less so after completing the forms. I think he was surprised to have a client who could tick the inpatient boxes and the high risk sections. I&#8217;m not sure he knew how to deal with someone who suffers from severe mental illness as opposed to the work-place stress and occasional bereavement that he will be used to. I may have been paranoid, but it almost felt like he was scared of me. Don&#8217;t get me wrong. He seemed nice enough and I think he would have been good with his usual clients, but it just wasn&#8217;t a fit.</p>
<p>So. I rang back the EAP and told them I&#8217;d quite like to see someone else if possible. The original telephone counsellor had made a point of ensuring I knew I could do this before the therapist was allocated, yet I still felt like a nuisance. They got back to me though and told me they were trying someone else. The next day I had a missed call and voicemail from DP, my old EAP therapist. His number was still in my phone so I knew it was him before I&#8217;d even checked the voicemail. He had remembered me. I don&#8217;t know if that is a good or bad thing. I called him back and we made an appointment for Wednesday.</p>
<p>I am in two minds about seeing him again. I&#8217;d mentioned the other day that I was secretly hoping I&#8217;d be referred back to DP, but I&#8217;m now wondering if that is wise. I guess at least I know that I can talk to him. He knows some of my history (although an awful lot has happened since our last appointment!!).</p>
<p>I&#8217;m scared though too. When I last saw him, I was one of those work-place stress and bereavement cases that EAP therapists are used to. I was not the mentally ill patient, that has been through the system. Admittedly I was in denial about my mental illness back then. It was definitely there and I even started to enter the system as a result of our appointments, but I hadn&#8217;t tried to kill myself, been in hospital and the rest. Will he know how to handle someone with severe mental illness or will he be just as clueless as last week&#8217;s therapist?</p>
<p>I also looked back through the emails we&#8217;d exchanged last year. I remembered with horror that I&#8217;d sent him the URL to this blog! After our appointments had finished we&#8217;d been in touch a couple of times. I&#8217;d given him an update as to what had happened after seeing my GP and telling my bloke. I guess the fact I shared this blog with him, shows that I trusted him, but I had never expected to see him again. I don&#8217;t know if he&#8217;ll remember. Shortly after I emailed him this blog was found by my partner and I stopped writing for a while. I suspect if he did read he would have given up then.</p>
<p>I wonder if I should just remind him this blog exists, but I am a little scared about sharing it with a professional, especially one who will be in touch with my GP and CMHT. It would be easier than explaining things though. We only have three appointments (the one with the first guy still counts from my allocated four), so it will help speed things along.</p>
<p>I don&#8217;t know. We will see what happens tomorrow.</p>
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		<title>Blogging Twit&#8230;</title>
		<link>http://intothesystem.wordpress.com/2009/12/07/blogging-twit/</link>
		<comments>http://intothesystem.wordpress.com/2009/12/07/blogging-twit/#comments</comments>
		<pubDate>Mon, 07 Dec 2009 17:47:53 +0000</pubDate>
		<dc:creator>intothesystem</dc:creator>
				<category><![CDATA[Into the system...]]></category>
		<category><![CDATA[blogging]]></category>
		<category><![CDATA[depression]]></category>
		<category><![CDATA[Facebook]]></category>
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		<category><![CDATA[just]]></category>
		<category><![CDATA[Nokia E71]]></category>
		<category><![CDATA[One in Four]]></category>
		<category><![CDATA[readers]]></category>
		<category><![CDATA[The Priory]]></category>
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		<description><![CDATA[Blogging seems to have been replaced by twitter lately. I can just about manage 140 characters at the moment, but proper blog posts are a little hard. Hence the fact I&#8217;m writing about twitter, rather than how I actually feel.
I don&#8217;t know how I feel about twitter.
When it first appeared on the scene a few [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=intothesystem.wordpress.com&blog=3960408&post=404&subd=intothesystem&ref=&feed=1" />]]></description>
			<content:encoded><![CDATA[<div class='snap_preview'><br /><p>Blogging seems to have been replaced by twitter lately. I can just about manage 140 characters at the moment, but proper blog posts are a little hard. Hence the fact I&#8217;m writing about twitter, rather than how I actually feel.</p>
<p>I don&#8217;t know how I feel about twitter.</p>
<p>When it first appeared on the scene a few years ago, I wasn&#8217;t sure about it and decided I spent enough time on Facebook. I didn&#8217;t need another site to absorb my time.</p>
<p>Then all of a sudden it was the next big thing and I wanted to avoid it because of the hype. I am generally adverse to hype. If a band is hyped to death I usually avoid them and the same applies to websites! I also got annoyed at the way it suddenly became this brand of innovation or a fashion statement. Join twitter and show how cool you are! I hated the celebrity culture that became attached to it too. All of this meant I pretty much avoided it like the plague and didn&#8217;t want anything to do with it.</p>
<p>But I&#8217;ve found that I often have things I want to add to this blog and I just don&#8217;t have the time. I thought about setting up some asides (a la <a title="Matt" href="http://codex.wordpress.org/Adding_Asides#Matt.27s_Asides">Matt @ WordPress</a>), so I can update when I have little time or if I am unable to find the words. In the end though it seemed easier to use Twitter with the WordPress widget. Add a small dose of peer-pressure to the mix and I capitulated. I think I signed up under this account in April. I don&#8217;t have a personal account and don&#8217;t think I ever will. I guess Facebook still serves a purpose for staying in touch with friends.</p>
<p>I barely used twitter at all in the first few months. I signed up whilst I was still in The Priory as I thought I might be able to keep things updated on my phone. Easier than typing full posts on the little qwerty keyboard of an E71. I kept forgetting twitter was there though and the arrival of a netbook meant I could update here instead.</p>
<p>Suddenly though over the past month my tweets have increased in frequency fairly rapidly and now I&#8217;m using it every day. I don&#8217;t know what brought about the change. Funny that my twitter frequency has increased inversely to my mood. Wonder if there is anything in that?</p>
<p>I guess you come around to most things in the end though. I resisted for a while but a surrender was always coming.</p>
<p>I seem to be collecting followers and readers now too, which is nice. I felt honoured yesterday that <a title="MarkOneInFour" href="http://twitter.com/MarkOneinFour/status/6433711599">@MarkOneInFour</a> plugged this blog on twitter and I certainly seem to have picked up some followers through that.</p>
<p>Anyway I don&#8217;t know where this is going really. I just started writing and before I knew it there was a post. I know I&#8217;m really writing this to avoid writing about how things are. They&#8217;re crap btw.</p>
<p>So if you ended up here through twitter. Hi!</p>
<p>Edit:<br />
p.s. I seem to have developed a tic with the word &#8220;just&#8221;. I&#8217;ve just (argh!) edited out a million from this post. Maybe I can start a new trend and it will replace the awful use of the word &#8220;like&#8221; that teenagers seem to love so much these days.</p>
<p>p.p.s. The original version of this was rubbish! Full of mistakes and the aforementioned &#8220;just&#8221;s. A little editing was in order. I guess the (lack of) quality of writing shows how bad my concentration is right now.</p>
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		<slash:comments>3</slash:comments>
	
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		<title>Started a Draft&#8230;</title>
		<link>http://intothesystem.wordpress.com/2009/12/03/started-a-draft/</link>
		<comments>http://intothesystem.wordpress.com/2009/12/03/started-a-draft/#comments</comments>
		<pubDate>Thu, 03 Dec 2009 22:41:10 +0000</pubDate>
		<dc:creator>intothesystem</dc:creator>
				<category><![CDATA[Into the system...]]></category>
		<category><![CDATA[blogging]]></category>
		<category><![CDATA[communication]]></category>
		<category><![CDATA[concentration]]></category>
		<category><![CDATA[Dr N]]></category>
		<category><![CDATA[mood]]></category>
		<category><![CDATA[writing]]></category>

		<guid isPermaLink="false">http://intothesystem.wordpress.com/?p=401</guid>
		<description><![CDATA[&#8230;but just can&#8217;t face finishing it right now.
I am really struggling at the moment. I can&#8217;t convey how things are, because I&#8217;m not sure I even know myself. I just feel completely out of it. I can&#8217;t think straight at all and can&#8217;t concentrate.
I have plenty to write about and so much floating around in [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=intothesystem.wordpress.com&blog=3960408&post=401&subd=intothesystem&ref=&feed=1" />]]></description>
			<content:encoded><![CDATA[<div class='snap_preview'><br /><p>&#8230;but just can&#8217;t face finishing it right now.</p>
<p>I am really struggling at the moment. I can&#8217;t convey how things are, because I&#8217;m not sure I even know myself. I just feel completely out of it. I can&#8217;t think straight at all and can&#8217;t concentrate.</p>
<p>I have plenty to write about and so much floating around in my head, but I just can&#8217;t communicate it. I struggled to explain things when I saw Dr N this morning and I&#8217;m struggling again now. I have thoughts about things I want to say. There are hundreds of half-written posts inside my head. A few already half-written on here too, but I am just not able to sort them out right now.</p>
<p>My head hurts. I think it&#8217;s time to hibernate.</p>
<p>I hope normal service will resume soon, but I&#8217;m not that hopeful. I&#8217;ll try. xx</p>
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		<slash:comments>7</slash:comments>
	
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		<title>Waste of Time&#8230;</title>
		<link>http://intothesystem.wordpress.com/2009/11/24/waste-of-time/</link>
		<comments>http://intothesystem.wordpress.com/2009/11/24/waste-of-time/#comments</comments>
		<pubDate>Tue, 24 Nov 2009 18:31:35 +0000</pubDate>
		<dc:creator>intothesystem</dc:creator>
				<category><![CDATA[Into the system...]]></category>
		<category><![CDATA[CMHT]]></category>
		<category><![CDATA[Dr D]]></category>
		<category><![CDATA[driving]]></category>
		<category><![CDATA[EAP]]></category>
		<category><![CDATA[EDT]]></category>
		<category><![CDATA[Enhanced Day Therapies]]></category>
		<category><![CDATA[J]]></category>
		<category><![CDATA[Liverpool]]></category>
		<category><![CDATA[Manchester]]></category>
		<category><![CDATA[medication]]></category>
		<category><![CDATA[mental illness]]></category>
		<category><![CDATA[Social Worker]]></category>
		<category><![CDATA[therapy]]></category>
		<category><![CDATA[work]]></category>

		<guid isPermaLink="false">http://intothesystem.wordpress.com/?p=395</guid>
		<description><![CDATA[So I saw Dr D today for the second time. My social worker came in with me, along with a junior doctor who looked about 12.
I didn&#8217;t know where to start. I had taken some notes with me which helped a little, but I&#8217;m not sure how much he actually paid attention. I ended up [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=intothesystem.wordpress.com&blog=3960408&post=395&subd=intothesystem&ref=&feed=1" />]]></description>
			<content:encoded><![CDATA[<div class='snap_preview'><br /><p>So I saw Dr D today for the second time. My social worker came in with me, along with a junior doctor who looked about 12.</p>
<p>I didn&#8217;t know where to start. I had taken some notes with me which helped a little, but I&#8217;m not sure how much he actually paid attention. I ended up having to explain most of my notes when he questioned me.</p>
<p>It seems he doesn&#8217;t really know what to do with me. He asked about antidepressants again, but when I reeled off the list of medication I&#8217;ve tried, he said I&#8217;ve pretty much exhausted the list. He decided to just leave my meds as they are. I&#8217;m a little disappointed about this. Although my current medication regime is the best combination so far (as in I haven&#8217;t gone *completely* batshit crazy on it), it&#8217;s hardly doing the job. I was hoping he&#8217;d have a suggestion of something else we could add. It just feels that by leaving the meds as they are, nothing is being done to try and improve things.</p>
<p>I brought up the subject of work and when I was likely to go back. He told me I&#8217;m still very ill and that I shouldn&#8217;t try to run before I can walk. Clichéd I know. I still find it weird when I&#8217;m told that I&#8217;m seriously ill. I guess as much as I do know differently, I still have those niggling thoughts that mental illness isn&#8217;t real illness. Everyone else&#8217;s prejudices still rub off on your subconscious.</p>
<p>I tried to push the subject saying that work were interested to know when I was likely to start a return to work. He just told me not to think about work. He just said the usual things about mental illness not having any exact time-scales. Apparently the CMHT are trying to get me better as fast as they can. I&#8217;m not exactly convinced. It feels like nothing has been done to try and get me better so far.</p>
<p>I also brought up driving and he just reiterated the need for me to be &#8220;stable&#8221;. He didn&#8217;t give any indication of what that means, just that I am not well enough to drive at the moment. Apparently all of these things will just happen when I am well again and I shouldn&#8217;t think about them. Easier said than done.</p>
<p>I mentioned the EAP therapy and he agreed that it might be helpful for me to have some support whilst waiting for the Enhanced Day Therapies referral to come through. Useless social worker, J was meant to chase up my EDT referral but hasn&#8217;t, so we shall see if she does it now she&#8217;s been reminded by Dr D. I think he was quite pleased to hear this about temporary therapy because it meant he didn&#8217;t have to do anything now himself!</p>
<p>The appointment didn&#8217;t last long and just felt like a complete waste of time. Apparently I will see him again early next year. No doubt it will be more of the same.</p>
<p>Regarding the EAP service. Yesterday, I was contacted by one of their counsellors to book an appointment. Unfortunately they were based in Liverpool, which is a two hour trek by bus from here (train would cost me money, bus is free!). I contacted the EAP today to ask if there was anyone I could see in Manchester. They&#8217;d linked me to someone in Liverpool because my address comes under Warrington, but Manchester is actually much easier and closer. Unfortunately all of their counsellors in Manchester are currently unavailable, but one comes back from holiday at the end of the week so they are going to ask them then. I guess we shall have to see what happens. If they can&#8217;t do it then I will probably give the Liverpool guy a go, but I&#8217;m not sure if it will be worth it with all the travelling.</p>
<p>Meh. I really feel crap now. Headache is raging (come on Propanolol! Work!!) and I just feel really demoralised by the crapness of the CMHT.</p>
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		<slash:comments>15</slash:comments>
	
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		<title>Doctors and EAPs&#8230;</title>
		<link>http://intothesystem.wordpress.com/2009/11/23/doctors-and-eap/</link>
		<comments>http://intothesystem.wordpress.com/2009/11/23/doctors-and-eap/#comments</comments>
		<pubDate>Mon, 23 Nov 2009 12:07:42 +0000</pubDate>
		<dc:creator>intothesystem</dc:creator>
				<category><![CDATA[Into the system...]]></category>
		<category><![CDATA[Beating The Blues]]></category>
		<category><![CDATA[bipolar disorder]]></category>
		<category><![CDATA[CBT]]></category>
		<category><![CDATA[CMHT]]></category>
		<category><![CDATA[counsellor]]></category>
		<category><![CDATA[diagnosis]]></category>
		<category><![CDATA[Dr N]]></category>
		<category><![CDATA[EAP]]></category>
		<category><![CDATA[Employee Assistance Programme]]></category>
		<category><![CDATA[ESA medical]]></category>
		<category><![CDATA[headaches]]></category>
		<category><![CDATA[HR]]></category>
		<category><![CDATA[mental illness]]></category>
		<category><![CDATA[occupational health]]></category>
		<category><![CDATA[OH]]></category>
		<category><![CDATA[OH assessment]]></category>
		<category><![CDATA[propanolol]]></category>
		<category><![CDATA[psychiatrist]]></category>
		<category><![CDATA[R]]></category>
		<category><![CDATA[risk]]></category>
		<category><![CDATA[Social Worker]]></category>
		<category><![CDATA[therapy]]></category>

		<guid isPermaLink="false">http://intothesystem.wordpress.com/?p=389</guid>
		<description><![CDATA[I saw Dr N on Thursday. It was good to have him back.
I wasn&#8217;t really with it at the appointment. I couldn&#8217;t focus and didn&#8217;t know what to say. I have felt pretty numb over the past few weeks and I couldn&#8217;t convey how I felt. At one point he just said &#8220;Are you okay? [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=intothesystem.wordpress.com&blog=3960408&post=389&subd=intothesystem&ref=&feed=1" />]]></description>
			<content:encoded><![CDATA[<div class='snap_preview'><br /><p>I saw Dr N on Thursday. It was good to have him back.</p>
<p>I wasn&#8217;t really with it at the appointment. I couldn&#8217;t focus and didn&#8217;t know what to say. I have felt pretty numb over the past few weeks and I couldn&#8217;t convey how I felt. At one point he just said &#8220;Are you okay? Have you been sleeping? You seem like you&#8217;re on another planet&#8221;. I told him that sleeping was a silly question, which he admitted, but he was right. I was very tired and vague. The fact he&#8217;d noticed though was good. It makes a change from other doctors that clearly pay no attention to how you really are.</p>
<p>I explained that I&#8217;d been having problems with headaches over the past couple months. I&#8217;ve literally had a headache every day for about 3 months, sometimes incredibly intense pain, other times just a dull ache, but nearly always there in some form. Beta Blockers are meant to be effective in preventing headaches, so he was a little concerned seeing as I&#8217;m already taking propanolol (for anxiety/agitation). We&#8217;ve decided to increase the dose and also switch to the modified release version so I&#8217;m now taking 160mg daily instead of 40mg b.d. Hopefully it will have some effect.</p>
<p>On Friday I got a phone call from HR. I have a new HR Rep, R. She introduced herself a couple of months ago, but hasn&#8217;t been in touch since. She was meant to call me regularly but hasn&#8217;t, so it was quite a long catch up. She asked me about therapy referrals, my social worker and psychiatrist. I told her there wasn&#8217;t much to say. Therapy referrals take forever, my social worker is still useless and I don&#8217;t see my psychiatrist until tomorrow.</p>
<p>She asked me when my last occupational health assessment was. It was over a year ago, so she said she will look into that again. I don&#8217;t know what an OH assessment will achieve. I get the impression they only want me to go so that work can say they are doing something to help. I don&#8217;t think there will be any pressure on me to get back to work, but I may be wrong. I guess it depends on the doctor I see. I have the same fears I had about the ESA medical. Fears they will tell me that I am making it all up and should just go to work.</p>
<p>If I do go, I wonder if I will see the same doctor as last time. He seemed to be pretty knowledgeable when it came to mental illness and was the first medic to suggest that Bipolar Disorder was a possibility. Shame it took a further 7 months before an agreement was reached on that topic. When I&#8217;d brought up his thoughts later with other doctors they didn&#8217;t seem interested. I guess they wanted to make their own decisions.</p>
<p>It may be useful to discuss work though. I haven&#8217;t managed to get much of an idea from the CMHT about when they think I will be ready to go to work. I am going to try and talk about it with the psych tomorrow. Dr N keeps asking me if I&#8217;ve heard anything from HR or whatever, but there hasn&#8217;t been anything to tell. I told him about my medical result too and I think he was a little surprised I&#8217;d been placed in the support group, although I think it also told him how ill I&#8217;d been on the day of the medical. I am not sure he quite understood how bad it was when I&#8217;d told him before.</p>
<p>The other thing R mentioned was regarding our company Employee Assistance Programme. I was told that they had been running a CBT trial and maybe I should consider asking about it. I told her I was pretty skeptical about CBT, but it could be useful to have some contact with a therapist whilst I am waiting for the NHS to do something. I agreed I&#8217;d give them a call anyway.</p>
<p>I was on the phone to the EAP for ages. First of all someone took my details and asked why I was calling. I explained I&#8217;d been told about CBT by my HR rep. She explained that they only offered telephone and online CBT (I&#8217;m guessing Beating The Blues!). I told her I wasn&#8217;t sure about that, but she said she&#8217;d put me through to the counselling team for an assessment and to discuss what might be helpful.</p>
<p>The counsellor was lovely. I explained I&#8217;d been on long-term sick leave for mental illness and that HR had suggested I got in touch. He asked me for a potted history, which I gave him as quickly as I could manage. At the end he just kinda went &#8220;oh, blimey&#8221;. I mentioned I&#8217;d had CBT whilst at The Priory and he asked me what I thought of it. I was honest and said that I was pretty skeptical and generally thought it was common sense, useful for mild depression, but ineffective for me. He asked me why I&#8217;d even bothered calling then, which was a sensible question. I said that I guess I thought it might be useful to have some contact with therapy whilst waiting for the NHS. Apparently his assessment of CBT was similar to mine and he didn&#8217;t think online CBT was going to be much help. He explained that usually a case like mine would be too complex for them to consider, but he wanted to help. He suggested that because I am waiting for long-term support, but I&#8217;m not getting the help I need currently, he felt it might be possible to refer me to the face-to-face service temporarily. It would only be four assessment appointments, but it might help me to work out what I want to work on when my NHS referral actually comes through. I agreed that this may be helpful. He asked me more questions then. Mainly about risk and safety. He stressed that his boss wouldn&#8217;t allow him to go through with it if they felt I was at too much risk. I had to give him the assurance I would be safe for the next four weeks, which was difficult even now. I am keeping myself safe at the moment, but I don&#8217;t know if or when that will change. At the end of the call he explained he would need to ask his boss to authorise my case, but hopefully it would be okay and then he wished me luck.</p>
<p>I am awaiting the phone call back to arrange my first appointment. He said if his line manager had refused he would call me back straight away and I didn&#8217;t hear anything, so I&#8217;m hopeful. I do think it could be good to just see someone for a few weeks. I don&#8217;t trust my social worker and have very little other support. In some ways I&#8217;m hoping it will be the <a href="http://intothesystem.wordpress.com/2008/06/23/since-thursday-13th-march-2008/">same therapist</a> I saw through the EAP back in April/May 2008, but I don&#8217;t suppose it will be, but you never know.</p>
<p>I need to go now. I have more to write, but no time. My bloke is going back to work part-time and I have the psychiatrist tomorrow. I guess I will update more soon.</p>
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		<title>The ECT Experience&#8230;</title>
		<link>http://intothesystem.wordpress.com/2009/11/17/the-ect-experience/</link>
		<comments>http://intothesystem.wordpress.com/2009/11/17/the-ect-experience/#comments</comments>
		<pubDate>Tue, 17 Nov 2009 13:44:33 +0000</pubDate>
		<dc:creator>intothesystem</dc:creator>
				<category><![CDATA[Into the system...]]></category>
		<category><![CDATA[anaesthetic]]></category>
		<category><![CDATA[bilateral]]></category>
		<category><![CDATA[bilateral ECT]]></category>
		<category><![CDATA[bipolar disorder]]></category>
		<category><![CDATA[Cheadle Royal]]></category>
		<category><![CDATA[cognitive effects]]></category>
		<category><![CDATA[depression]]></category>
		<category><![CDATA[diagnosis]]></category>
		<category><![CDATA[Dr P]]></category>
		<category><![CDATA[Dr Shock]]></category>
		<category><![CDATA[ECT]]></category>
		<category><![CDATA[ECT side effects]]></category>
		<category><![CDATA[electric shock therapy]]></category>
		<category><![CDATA[Electro-convulsive Therapy]]></category>
		<category><![CDATA[hope]]></category>
		<category><![CDATA[jaw pain]]></category>
		<category><![CDATA[long-term effects]]></category>
		<category><![CDATA[memory]]></category>
		<category><![CDATA[memory loss]]></category>
		<category><![CDATA[shock therapy]]></category>
		<category><![CDATA[side-effects]]></category>
		<category><![CDATA[The Priory]]></category>
		<category><![CDATA[treatment]]></category>
		<category><![CDATA[unilateral]]></category>
		<category><![CDATA[unilateral ECT]]></category>

		<guid isPermaLink="false">http://intothesystem.wordpress.com/?p=386</guid>
		<description><![CDATA[Whilst I was having ECT I never really wrote about it. I was in hospital with only mobile access to the Internet. I was exhausted, often in pain and not really in the mood for writing. Recently though I&#8217;ve been inspired by this blog and Seaneen&#8217;s appeal for ECT info to document my experience. I&#8217;m [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=intothesystem.wordpress.com&blog=3960408&post=386&subd=intothesystem&ref=&feed=1" />]]></description>
			<content:encoded><![CDATA[<div class='snap_preview'><br /><p>Whilst I was having ECT I never really wrote about it. I was in hospital with only mobile access to the Internet. I was exhausted, often in pain and not really in the mood for writing. Recently though I&#8217;ve been inspired by <a href="http://throughect.blogspot.com/">this blog</a> and <a title="appeal for ECT info" href="http://thesecretlifeofamanicdepressive.wordpress.com/2009/11/09/blogs-forums-and-resources-on-ect/">Seaneen&#8217;s appeal for ECT info</a> to document my experience. I&#8217;m worried that if I don&#8217;t do it now, I&#8217;ll forget what happened all together.</p>
<p>Ultimately my experience with ECT was a failure. I had 11 treatments, some unilateral and some bilateral. I barely responded at all and in the end we gave up.</p>
<p>ECT was seen as the last resort. I was about as severely depressed as you can get and no one knew what else to do. I wasn&#8217;t sure about having it, but at the time <a title="anything is worth a try" href="http://intothesystem.wordpress.com/2009/03/02/in-for-a-shock/">I wrote that anything was worth a try</a>. I think I was so depressed I didn&#8217;t really care what happened to me. I know I secretly wished it would go horribly wrong, so overwhelming were the thoughts about death.</p>
<p>I went into the treatment with a smidgen of hope. I felt little, but I knew my family wanted it to work. We had to believe it would work, as the alternative was too horrible to comprehend. Other patients at The Priory had been through ECT and come out the other end much improved. ECT had been lifesaving and I hoped it would be the same for me.</p>
<p>The proceedure was a lot less scary than I had feared. We were woken early by the nurses, our blood pressure and temperature taken, then we were bundled into a taxi with the nurses over to Cheadle Royal. The Priory doesn&#8217;t have an ECT suite anymore, so treatments were taken there.</p>
<p>There was a waiting room, where we&#8217;d sit waiting our turn. There was usually three or four of us being treated at the same time. Three from The Priory and a day patient from elsewhere. Eventually we&#8217;d be called into a prep room, where a girl would wash our forehead and neck and attach EEG stickers. Next we entered the treatment room. We&#8217;d climb onto a bed and Dr Shock would ask us how we felt. We would be attached to the monitors and then the anaesthetist would take my hand and try to insert a cannula.  This was where it got difficult to me. My veins are small and deep and finding one proved near impossible at times. Multiple attempts, hands like colanders and a number of bent needles later and we would be ready to go. After a few treatments like this, the anaesthetist ordered some microwave lavender bags, which I&#8217;d be given to warm my hands. ECT quickly became associated with the smell of lavender.</p>
<p>I&#8217;d never had a general anaesthetic before my first treatment and I didn&#8217;t know how I&#8217;d feel. I soon got used to the feeling. Twice a week for nearly 6 weeks, you have little choice. The liquid would ooze into my veins and I&#8217;d drift off. Next thing I knew I was in the recovery area, oblivious to what went on whilst I was asleep.</p>
<p>Throughout my treatment and since, I&#8217;ve always been curious to see what happens in between those moments. I often wondered about asking if I could watch someone else go first, but was certain I&#8217;d be turned down. I know they apply a current to my brain and I have a fit, but what does it actually look like? Who does what?</p>
<p>A few times I awoke covered in blood. The cannula would slip out during the fit and I&#8217;d be left with a red tshirt.</p>
<p>As we woke up our vitals were taken regularly. Each of us would have a nurse, who would keep a close eye on us, administering pain relief if required. It was always required. An hour after our treatment we would be allowed up and given tea and toast, or water and toast in my case. Then we were bundled back into the taxi and taken back to the ward, where we usually went straight to bed.</p>
<p>At the time, the side effects weren&#8217;t so bad. I usually had a thumping headache, more so after the bilateral treatments. Sometimes I would ache all over. My jaw was often painful. My appetite was normally dodgy and I felt queasy from the anaesthetic. My memory seemed to be pretty much in tact. I&#8217;d written all my passwords and things down before I went, but I don&#8217;t think I ever needed to refer back.</p>
<p>I didn&#8217;t really mind the treatments, but I was frustrated at the lack of response. The night before each treatment we&#8217;d be given the BDI and would tick the boxes and I couldn&#8217;t see any improvement. I know my scores did improve a little, but one or two points is nothing and the miracle I was hoping for never materialised.</p>
<p>One of the girls having ECT with me improved rapidly. She was discharged before I&#8217;d even finished the treatment. The other improved gradually, but she did improve. I seemed to stay the same.</p>
<p>Dr Shock would ask me each time how I felt and I never knew what to say. She would tell me I looked brighter, but it felt like she was only saying that to convince herself it was doing some good, not because she really believed it.</p>
<p>Towards the end, I knew we were running out of steam. I could see the medics were giving up. When the decision was finally made I wasn&#8217;t surprised but I was disappointed. I felt like a failure and I felt annoyed that it hadn&#8217;t worked. It was meant to be the cure and it failed. I felt like I should have tried harder. I worried it was my fault and that everyone thought it was my fault and that I just didn&#8217;t want to get better.</p>
<p>Afterwards came the assessment from Dr P and the diagnosis of Bipolar II Disorder. It was suggested that my lack of response to &#8220;traditional methods of treating depression&#8221;, showed that I wasn&#8217;t suffering from &#8220;straight&#8221; depression. I had suspected that for a long while before, but I don&#8217;t know why it took ECT to decide this. I am grateful for the ECT for accelerating this diagnosis, but it seems an awful lot to go through just to get another assessment.</p>
<p>The long term effects of ECT have only been showing themselves over the last few months. I didn&#8217;t think the memory loss was significant, but as you go through life there are reminders of what is missing. People mention things that happened and I have no recollection of them at all. Silly things like ordering a meal in a restaurant commenting that &#8220;I&#8217;ve not had this before&#8221;, only to be told that I did back in April when I went there with my parents. Not only had I forgotten my order, but I&#8217;d forgotten I&#8217;d even been there with my parents.</p>
<p>It&#8217;s not just from the treatment period either, but before too. A lot of last year has disappeared and I only have my blog and my family&#8217;s memories to remind me. Distant memories that were once clear are now fuzzy or gone completely. I have lost a lot more than I&#8217;d realised at first. They say that the memories will come back with time, but I seem to be forgetting more, not less. I don&#8217;t know if it&#8217;s just because as time goes on I find out about more of what is missing.</p>
<p>I don&#8217;t think my short term memory is that bad. I am forgetful, but I&#8217;ve always been a little. For most people it is the short term memory that is worst, but I seem to have got off fairly lightly on that front. I guess this is something.</p>
<p>I&#8217;ve alluded to this at other times, but I think ECT has had an effect on my thinking ability too. It&#8217;s hard to know for certain, as depression can stunt your cognitive abilities too, but I am not as sharp as I used to be. My partner often says that I&#8217;m slow. I am not very quick on the uptake at times. I find it harder to think and harder to solve problems. My arithmetic seems worse than before.My concentration is poor. Even when I&#8217;ve been a little high, I don&#8217;t feel as capable as I did before. Things I used to find easy can be a challenge. I feel like I&#8217;m a little blunted. I pride myself on my intelligence, yet I don&#8217;t feel as bright. I wonder if I&#8217;ll ever regain what I used to have and if this will improve.</p>
<p>Along with the memory and cognitive effects, there is a physical side effect. The right-hand side of my jaw has been problematic ever since. It locks and it grinds. Sometimes I can&#8217;t open my mouth at all. Other times I get shooting pain right through the side of my head, where my jaw is stuck or out of place. I don&#8217;t know if there is a solution, but I suspect I will be stuck with this for ever now. It may not be anything major, but it can hurt and is annoying.</p>
<p>I don&#8217;t think I&#8217;d mind these effects at all if ECT had worked. If I was now stable and free of depression these issues would be worth it. It&#8217;s just that for it all to be in vain, it seems a lot to go through for no gain.</p>
<p>I am still disappointed. ECT had been that final resort and was something I could hold in my mind as a possibility for change. For me, I always need to know that there is another option and this was just another one that we have exhausted. When I have run out of options then I will really give up. I don&#8217;t think I&#8217;d go through it again, even though for some it can work a second time when it had not the first.</p>
<p>All that said, even though ECT didn&#8217;t work for me, I still wouldn&#8217;t discourage people from trying it. You have to weigh up the potential benefit with the possible effects, but if it works, I think it is worth it. It is usually only used when all else has failed and in that case what else do you have to lose? I have seen it work for others, I am just jealous it didn&#8217;t for me.</p>
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