Into the system…

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Archive for June 2009

Stuck at the bottom…

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I seem to have stopped yo-yoing and am now stuck at the bottom. You know when you’ve failed to keep the yo-yo going and it just sits at the bottom dangling? My mood is like that.

My week has been one of low mood, but less agitation. I just feel flat,  and demotivated. I just want to hide away and never have to go out and face the world. I just want to hibernate and never wake up. I just want to be dead.

I saw Dr G yesterday with my bloke. It was difficult for me to speak, as usual when he is around, but we talked about activity scheduling and planning. This is something that I am often told to do, but I find it really difficult. I hate the idea of planning what I am going to do in advance rather than just doing things when you want to. I know it is meant to help my motivation but instead it just feels like a chain around my neck. I find it hard to stick to the plan. So far I am doing just a day or two ahead and have been trying to stick to it but I don’t like it.

My partner keeps moaning that I should show more enthusiasm and do exactly as my psychiatrist says, but I have done activity planning in the past and only found it a chore. He keeps saying that I am not helping myself and doing everything I can to get better. I find it so demoralising because I am trying and doing my best. It feels like no one can see how much effort I am putting in. I find just existing hard enough. I am constantly battling the thoughts and doing everything I can to keep myself safe even though I don’t want to, or at least the thoughts tell me I don’t want to. It’s exhausting and bloody hard work. I am fed up of fighting. Why should I have to work so bloody hard to get better? I have done so many of the self-help and self-soothing things that I am fed up of them all. I monitor my thoughts, mood and activity. I try to do all the things that are meant to help my sleep. I try to eat well and maintain a routine. I try distraction. I still don’t feel any better though. Right now I feel as bad as ever. I don’t want to be safe.

I am feeling really demoralised right now. Everyone else seems to be getting better. Most people I know at The Priory are well on the way to recovery. Quite a few have finished or are finishing day care. I feel left behind. I know I finish day care in a few weeks but that’s not out of choice or because I’m better; it’s because my funding runs out. I’m no where near better. Although I know I’ve made progress and am now able to communicate with doctors how I’m feeling, that’s the only real improvement. My mood is still on the floor and I’m still struggling with agitation and mood swings. I’m still so very ill. My medication is still being played with and I stop seeing Dr G in a couple of weeks. I’m terrified of being stuck in limbo whilst I am passed from The Priory to the NHS.

I did eventually hear from the CMHT yesterday. My worker called me and wanted to arrange to come and see me. I’m away for some of next week so she can’t see me until 1st July. It seems like a while to wait. Especially considering my funding runs out the week after that. I want to know that I am actually going to have some support in the NHS. I want to know that I have a consultant to carry on adjusting my medication. I’m worried. I know that in the NHS you will not see the psychiatrist weekly. I know I’ll be lucky to see them every couple of months. I don’t know if I can last a month between medication changes. The thought of being stuck with no hope of any improvement of change for months on end is incredibly depressing and enough to make me give up. I’ve got used to the care offered at The Priory. I’ve got used to seeing Dr G every week and her making little changes where necessary, even in between appointments on occasion. I really don’t want to be dumped in the NHS. I am worried I’ll be left to rot.

Sexuality…

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I initially started this post last July when there was a discussion about the lack of gay mental health blogs from both Lexie and Aethelread but I never got around to completing my post and following them up myself.

More recently Kate got me musing on the subject of sexuality again and I thought it was time to resurrect the draft that I started so very long ago.

Like last time, it may take me a while to work out what I want to say and I don’t know if I’ll ever manage to complete it. It’s a topic that is still so very tangled in my head despite going through a whole battle of acceptance a few years ago.

In particular I remember from the initial discussion that, Aethelread said the following:

On the one hand, I think it can lead to us being so keen to stress that being gay has nothing to do with mental ill-health that we decide not to mention our sexual orientation when we blog about our MH problems.

For me, I think this hits the nail on the head. I’m not sure that it’s because of guilt as he suggests, but I think the reason I’ve not mentioned my sexuality before, is that I do genuinely believe it is unrelated to my mental health.

For those who have been reading my blog so far, you would be forgiven for the assumption that I’m straight. I’m in a long-term relationship with a man – a decidedly heterosexual arrangement. In fact, I’m engaged to that man. However, my sexuality isn’t that straight-forward (if you will forgive the unintentional pun!). I have always hesitated to attach this label to myself, because it’s not one I particularly like the sound of, but it is the one that fits. I’m bisexual.

In many ways I am lucky in that I can always let people have their assumptions. It is entirely my choice whether or not to disclose my sexuality and it is nice to have that choice, but then again if I was straight I wouldn’t need to make that choice, would I? My relationship with my partner makes it even easier for people to assume I’m straight, but I find that difficult at times. It often feels like I’m hiding part of my identity and not being honest about who I really am. It’s something I’ve struggled with because I don’t want to have to shout from the rooftops that I’m not straight, but then again I don’t want to hide matters either. I wish that bisexuality was commonly accepted and that people didn’t make assumptions that you are either gay or straight based upon your current partner.

As for my sexuality and its involvement in my illness, I do not really think there is much of a connection. I have battled with acceptance in the past and things have added to my confusion at times of crisis, but it’s not something that is directly responsible for my mental health problems. This is something that thankfully my therapists and Dr G at The Priory have agreed with me on.

It took a long time for me to even bring up my sexuality at The Priory because I was scared that it would be blamed for my issues. At the time, I was really scared that my bisexuality would be seen as another reason to slap on an unstable (borderline) personality disorder label – after all, uncertainty over sexuality is meant to be a trait. The thing I wanted to make clear was that I was no longer uncertain about my sexuality; I had accepted the fact that I like both men and women. I was scared that my sexuality would change the way people saw me. I was scared that it would become a problem because everyone else thought it was. I was scared about prejudice.

It got to the stage though that I felt it was becoming a problem because I was hiding a part of me. I kept thinking about it and it felt like I was living a lie. When you are going through therapy I guess it’s important that every part of you is on show. I felt that I needed to be honest and open up about things. I didn’t know how I could do it. I wrote to Dr G in the end. Thankfully my fears weren’t realised and she was very supportive.  My issues with my sexuality were boxed up carefully to be treated as a side problem, not the main affair, and everyone seemed to agree with me that we couldn’t use my sexuality as a scapegoat for my mental health issues.

As for what Kate wrote, I know how she feels. I have been through many of the same thoughts and issues over the years. The issue of acceptance is a difficult one and I think it’s something that I will always have some issues with. I also understand the fear of bullying, the fear of being different and the fear of scaring off your friends, especially female ones who may think you’re hitting onto them. Coming out is scary.

One of the things that made it so hard for me to accept that I liked women was the fact I used to be bullied and one of the things they used to say was “Lesley, the lesbo”. (oops, there goes my real name.. let’s just leave it hidden here and hope most people don’t notice!). An unoriginal put down considering my name, but one I used to hate. I began to associate being a lesbian with bullying, so it’s no wonder I was reluctant to admit I liked girls.

Another reason was my mother. I remember when there have been stories about lesbianism on TV she would always say how disgusting it was and would always expect me and my sister to say the same. She had no issues with gay men, but couldn’t accept lesbianism at all. This of course is difficult, because you don’t want to go against your family’s expectations. I don’t want my mother to be repulsed by me. This is why my mum will never know. What she doesn’t know won’t hurt her and it’s easier for her to just assume I’m straight. If I wasn’t with my partner and was going out with a girl I guess things would have to be different, but I guess I’m lucky in that way.

Being bisexual I think there are added issues. Homosexuality is becoming more and more acceptable, but there are still prejudices towards bisexuality from both the straight and gay camps. Biphobia takes many forms, but generally there’s a belief that bisexuality doesn’t exist or there’s an assumption that bisexual people are promiscuous. I may not be fussy, but that’s because I see people for what they are and am not bothered about gender, not because I just want to shag anything that moves.

I often feel like I don’t fit in. I am not straight, but I am not gay either and that leaves me caught. I feel as if I don’t know where I belong. Although I am in a relationship with a man, that doesn’t mean I want to live an entirely heterosexual existence. Doing so would be denying the other half of me that is just as interested in women. It’s a difficult one and one I don’t think I’ll ever really overcome.

I think I’ve rambled enough about this for now. As I said before, I still struggle to untangle all my thoughts on the topic and as such my writing is confused. I don’t really know what I wanted to say, other than to come out here too.

Written by intothesystem

Tuesday, 16th June 2009 at 2:25 pm

Yo-yo…

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I’ve been up and down like a yo-yo this week. Since the crash back down last weekend I was up again Sunday night and quite hypomanic, giggling unnecessarily and unable to sleep. Monday was a slightly more even day before a complete meltdown on Tuesday. I was highly emotional, stressed out, suicidal, angry, hyper and generally out of control. I couldn’t control the agitation or my emotions and ended up crying and laughing hysterically. It was almost as if I just couldn’t cope with the tension that was mounting inside me and I didn’t know what to do, so my mind and body went totally crazy. I was all over the place, felt really out of control and generally not in a good way.

My meltdown on Tuesday also saw me telling my other half that I wanted to break up and couldn’t cope with our relationship. I just want things to change and at the time it felt like the easiest thing to change would be for us to break up. I clearly wasn’t thinking straight (breaking up would be far from easy!), but it does scare me that when I get like that I want to push him away so much. I really was hysterical and I wonder if my out of control emotions are trying to tell me something. I don’t really know if I can cope with this relationship much longer, or rather I don’t know if this relationship can cope with this illness much longer. I suspect my doubts are just another sign of me wanting to isolate myself so it’s easier to do the deed, but I don’t know.

I find myself wanting to be on my own for many reasons. Yes, it would be the loss of another “protective factor” and would make it easier to kill myself, but I know that our relationship didn’t stop me trying in the past and when I’m in that state of mind it wouldn’t stop me again. I do want to be on my own though and not have to worry about how my behaviour affects my partner. I wouldn’t have a battle every time I want to stay in bed a bit longer because the illness is holding me there. I wouldn’t be feeling like I was a child under his control because I’d be able to go out whenever I wanted without having to ask permission. I could learn to cope with things on my own and I think that would help me to re-engage with life again. At the moment I don’t feel that I can.

There are of course many reasons to stay together and for balance I guess I should mention those too. We’ve been together a long time and been through a lot and there is no reason why we can’t get through this too. I do love him very much and although I struggle with that love a lot of the time it is still there. There are practical things like we live together, have joint bank accounts etc that make division difficult – we can’t just stop seeing each other. Generally, splitting up would not be easy even though sometimes it feels like the easy option.

Seaneen once wrote that her illness, or rather the possibility that she might kill herself, is like a lodger within her relationship and I know what she means. There’s this third person that gets in the way all the time and makes things more complicated. This illness, especially the risk of suicide, is something that intrudes on every aspect of your relationship and makes it very difficult for things to be okay. There is always going to be that fear and this means there’s an imbalance of power. For us at the moment, it feels like it’s the illness in control and the illness with all the power. I feel like the lodger is getting in the way all the time and I don’t know if we can learn to live with it. My partner just wants everything to go back to how things were before, but that just isn’t going to happen. I don’t know. I hope we can get through this in one piece, but I’m not sure it’s guaranteed.

Anyway, Wednesday was a really low day. I was getting fed up of the turbulent nature of my moods and just wished that things would sort themselves out. I had no motivation and just wanted to hide from the world. Hibernation would have been nice. Suicide would have been nicer. I just had no desire to live. I still don’t most of the time. I wonder when that is going to change.

Thursday was a day of medical appointments with me seeing Dr G and Dr N. Dr G’s appointment was fairly uneventful. She didn’t want to increase my lamotrigine again so soon as it has to be titrated up very slowly. She did however add an extra 1mg PRN to the haloperidol so I’m taking 2mg regularly now and the additional 1mg if I get agitated.

We did talk about a few practical things though. It seems I do need to notify the DVLA about my condition and it is likely my license will be taken off me. When I last asked her about it a long while ago, prior to the suicide attempt in February and my Bipolar diagnosis she told me I didn’t have to, but things have changed. I guess my condition is taken more seriously these days.

We also talked about Disability Living Allowance. Dr G says I should be receiving it. It seems I should have applied a while ago but I didn’t know. It’s a shame that it cannot be backdated either. I spent Thursday night trying to put together my application. The form is a complete bitch and took me hours and I still don’t know if I’ve told them enough to convince them that I am deserving and ill enough. It doesn’t seem very geared up for people with mental illness. Lots of questions about personal care and mobility and little opportunity to explain just how much of a bitch living with mental illness is. I just hope that Dr G and Dr N can convince them for me. I’m dreading a medical assessment as I just don’t know if I can be honest with a new doctor. I suspect I would come across as too high functioning or maybe I’ll just be so anxious I can’t speak.

My trip to Dr N was disappointingly brief, but I had little to say really. Not much has changed. He just looks at me with pitying eyes these days whilst administering the necessary prescriptions. I only realised afterwards that the haloperidol supply he’s given me only covers 5 days if I use all the PRN. I haven’t been doing, but even still that’s not ideal. I don’t want to have to go back to him too soon. I feel like I am wasting his time. It’s bad enough being on weekly prescriptions and having to waste his time seeing him every week when I don’t really have anything new to say to him.

My mood on Friday was up and down just in a day. I started the morning low, but felt better by lunchtime. I had a good afternoon with Chouette, Kate and Hannah. It’s nice to talk about things and know that they understand, but it’s also nice to chat about normal things like university and living in Manchester. In the evening I went for a meal with some uni friends and although it was nice, I was tired and struggling to engage. My mood was falling throughout and by the time I got home it was on the floor again. I had to try and keep up appearances for a little longer whilst people were around.

Afterwards, things became difficult. My partner was upset and wasn’t talking to me. I don’t know what I had done to deserve that. I felt awful and couldn’t find out what was wrong. I was exhausted and wanted to go to sleep, but couldn’t because again our relationship was struggling because of this illness. I am fed up of it.

Yesterday was a long day. I was so busy it was hard to know how I felt mood wise. I was low but distracted. I’m just glad it is over I think.

More Shifts…

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It seems I may have entered the land of rapid cycling again. A week of agitated depression has shifted back into plain old depression. I’m still a little agitated and the thoughts are still muddled and racy, but that’s part of the course. My depression is always like that, however I’m no longer jiggling about like a cat on a hot tin roof and full of the energy to act upon the intrusive thoughts.

The shift began yesterday, even before the additional medication was brought into force. Taking the haloperidol pushed things that extra notch. I’m already missing the energy, if not the agitation. I did get some sleep last night, which makes a change but I am tired again. Before, I wasn’t sleeping but I wasn’t really tired either. I had all the energy in the world, albeit not with the concentration to follow my flying ideas though. Now I am left just wanting to hibernate and feeling like crap. I wish I knew where I stood.

I don’t know if to keep taking the haloperidol tonight. I feel I should just follow the psychiatrist’s instructions, but I don’t think she expected me to crash back down quite so quickly. I certainly didn’t expect it to happen so soon. On Thursday, it felt like the agitation was going to last forever and only get worse. Instead, two days later, things are different and I’m really not sure I need to be sedated to the same extent. The extra sleep is a nice change I guess, but I’m not hypomanic anymore, so should I really be taking medication used to control mania?

Considering all of these changes in mood have happened since starting a new mood stabiliser, I wonder just how stabilising this medication is. I know it is early days, but so far I’ve just gone from being constantly suicidally depressed to all over the place. I really don’t know what’s going on. One minute I’m full of beans, albeit with a nasty edge of suicidality and the next I’m lethargic, suicidally depressed but unable to motivate myself to do much of anything. I know I’m safer like this, but it isn’t a nice place to be.

I’ve also started logging my mood again. I had homework from Open CBT to log my activity and stress levels, so whilst doing that it made sense to start logging my mood and agitation too. I was told to a while back and did it at first then kept forgetting. I think it will be helpful to see where the shifts are, but it’s difficult to rate things. When you’re depressed, by nature I think you can be quite negative so I wonder if I am rating things lower than perhaps I should. I don’t know how to rate my mood when I’m always suicidal, even though sometimes my mood may be overall a little higher. How on earth do you show mixed states? Over the past week my presiding mood has been full of the energy of hypomania but with the suicidal side of depression. If I rate my mood negatively (ie as depression) how do I distinguish from the times when I don’t have masses of energy? I don’t know. I guess that’s where the agitation ratings come in. Anyway, I’ve tried to put something together but I’m not sure how useful it really is. I guess I will stick with it for a while, but I probably won’t keep it up like last time. Does anyone else rate their mood and how do you do it?

Or perhaps it does…

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I last wrote that nothing changes. No sooner than I say that, things seem to be shifting. Things have changed, but I’m not sure that it’s a good thing. Coming off the Depakote and increasing the Lamotrigine appears to have given me loads of energy and is doing something to my mood. Over the past week I have felt this happening and have not known how to stop it and slow things down. I’m now agitated to the point of hypomania, yet still suicidally depressed and I know this is a risky place to be. I’m in the land of agitated depression. My thoughts race, but are largely negative, suicidal and destructive.

My sleep is bad. I think I’m getting a couple of hours at most. At 3.30am last night, I hadn’t slept a wink. I just seem to spend all night tossing and turning, feeling restless and unable to settle with thoughts racing through my head at a million miles an hour.

I’ve ended up seeing Dr G twice this week. I saw her on Tuesday with my partner. This was similar to the last appointment when he came, in that I felt unable to speak and extremely anxious. I become restless and fidgety, which doesn’t help as afterwards my bloke was moaning that I was rude and didn’t seem like I was listening. I was doing my best, but it is hard to follow things when you’re so anxious and your head is doing its best to distract you.

Generally I wasn’t able to be honest with her about how I was feeling and although I mentioned the agitation, I didn’t warn her how destructive I’ve felt. I was quiet and had little to say.

We talked about how I hadn’t heard from the CMHT yet. Dr G said that she still hadn’t spoke to Dr B, but she thinks she knew which psychiatrist it was and she was happy to pass my care onto her. Dr G also said that she hoped to set up a CPA meeting with everyone involved including the CMHT, so we shall see if that ever materialises. She also asked me to give the Allocation team a call to see if they knew what was happening. I did afterwards and it seems I’m being allocated to team this week, so should hear from them soon.

I can’t really remember what else was discussed except the inevitable increase in Lamotrigine. I knew it was coming really.

Yesterday, I saw my GP, Dr N to get my prescriptions and to sort out my sick notes. He was lovely as always and listened to my honest assessment of how things are. He was concerned and tried to get me to promise to use the crisis team if I need it. I just don’t know if I can. My last experience of them was terrible and I just don’t have the self confidence to call them, especially when I’m in a crisis!

Today I had a support group at The Priory and was really agitated and struggling to control the racing thoughts. I managed to be quite honest about how I’ve been feeling, which only caused worry. The therapist, D was doing her best to get me to agree to keep myself safe and to find ways to look after myself. She tried to get me to ask to see Dr G today instead of waiting until next week, but I really didn’t want to do that. She tried to get me to tell my bloke not to go out and leave me alone this evening, but I really didn’t want to do that either.

Following the session, D came over to me and said she’d talked to Dr G. Next thing I knew, Dr G was asking me up to her room. I was able to be more honest with her, although I had to be knowing that the therapist had already filled her in on the basics. I was honest about the agitation and the fact I could feel my mood was shifting. I told her I feel like I’m on the edge and that I don’t know what’s going to happen. I know I can be impulsive when I’m like this and I have all the energy I need to act on these thoughts, something I’ve not had recently. I told her that my partner was out for a few hours this evening and I was scared that I’d take the opportunity whilst it presented itself. Even as I write this, my head is telling me I should be making the most of the opportunity because I might not get another for a while.

Dr G said that she thinks I need medication to help bring things back under control. She wanted me to up the Lamotrigine again and talked about introducing Lithium when I next see her. This change in mood is only making it more obvious that Bipolar is the right diagnosis. She also wanted to give me some short term medication to bring things under control whilst the other meds are titrated up to a therapeutic dose. She wrote me a note for some Diazepam and a few days of Haloperidol. The idea was I’d get a prescription from my doctor this afternoon and then dose myself up so I couldn’t do anything this evening. Unfortunately getting a script today was impossible as Dr N wasn’t working and the stupid receptionist would not agree that it was urgent so wouldn’t push the prescription through as an emergency. Her argument was that the specialist would have given me the medication if she wanted me to start immediately. She wouldn’t listen to the fact that The Priory only issue medication on the ward, don’t have a pharmacy service and didn’t issue me a private script as that would cost me a fortune.

I was glad I got pushed into seeing Dr G as it was a good appointment for once. I was pretty honest and managed to speak up that I needed help. She was concerned, but I think she was pleased that I was able to say something, even if I wasn’t given any choice in the matter by D.

I see her again sometime next week and we’ll discuss the Lithium again. I don’t really know what I think about it. Lithium brings the reality of my diagnosis to the forefront of my mind. I am not too bothered about the blood tests, but I worry about side effects. Mainly I just hope that it works. It’s always been seen as the last option for me and now Dr G is reaching for it. I wonder what happens if it isn’t the drug for me. Do we persevere with the Lamotrigine and hope that can handle things on its own? Do we give up on drugs all together? I don’t know. I guess these are questions for the qualified, questions for the psychiatrist to answer.

Anyway, the evening has come and I’m on my own. I’m trying to keep myself distracted and to keep things under control. I was going to do some painting but I keep staring at my paints and canvases and don’t know what to do.

Instead, I just sit here, unable to stay still and trying to write. I am finding it hard to extract my entry from the muddle of thoughts and words that are in my head, but am doing my best. It is taking longer to write than normal even though everything is going so fast. I think I could stay here rambling for hours, but I am sure it will get boring for everyone and I doubt I’ll make much sense. I’m surprised that what I’ve written so far seems to be half coherent. It doesn’t feel very coherent in my head.

I can feel the agitation on the increase. Things calmed down a bit this afternoon, but I am back up again. I don’t have long left on my own, so I think I can get through it. I hope tonight that I can get some sleep and that things slow down soon, but I don’t know that they will. It only feels that things will get faster and faster at the moment until I fall over the edge or crash into something. Hopefully the medication will settle things down if I can eventually get some tomorrow.