Days pass by…

I’ve been wanting to write for days now, but not got around to it. Things keep coming up or I get distracted.

I saw Dr N on Friday. It was the first time I’d seen him in weeks. First there was the secretary screwing up incident, then I was at Glasto and then he was on holiday for a couple of weeks. I’d missed him, but we didn’t have long to catch up, as is the norm with GP appointments. I told him I’d met my CMHT worker. When he asked if she was a CPN, he was pretty surprised and seemed disappointed when I said I had a social worker instead. I don’t think I’m the only person to be sceptical about the usefulness of a social worker. I left soon after with a new sick note and a couple of scripts.

On Friday night I took the increased Nitrazepam dose (20mg)  for the first time. Had a night of restless sleep, but more than I had been getting before. The problem is it sent me bat-shit crazy.

I woke up in the blackest of black moods. Far worse than anything I have experienced of late and that is saying something considering my mood over the past few months. My mind was focussed on one thing and I was agitated, irritable and highly emotional. I woke up with a splitting headache and generally felt terrible. I spent most of the morning in bed, virtually unable to stand my head hurt so much and completely unwilling to face the world.

In the afternoon, my bloke insisted on dragging me out to The Peak District with the dog. I felt awful and was not in the mood at all, but didn’t have much choice in the matter. During the walk I was angry and upset and unable to control myself. I was crying and shouting and taking everything out on my partner. At one point we stopped at a bench, my bloke determined to talk to me and find out what was wrong. I was pretty much screaming at him that I hated him and just wanted to throw myself off a cliff. There was one point when I realised that we were close to a steep drop down to the reservoir below and I walked straight at it contemplating a jump. It was enticing me, calling to me. I don’t think it would have worked, but it was all I had at the time. My partner was quick to respond, realising what I was considering and restraining me, pulling me from the edge. I did my best to try and calm down and we carried around the walk and then went home, myself occupied by the black thoughts, occasionally bursting into tears for no real reason. I spent a lot of time wishing I’d been quicker at the edge.

Sunday was miserable too. I’d taken the higher dose again, unsure if it was the Nitrazepam or something else that had caused the dramatic swing downwards. I was less out of control but just low and lethargic. The headache was even worse than the previous day. At puppy school I couldn’t stand up for the pain and had to leave my bloke to do most of the training.

I reduced the dose on Sunday night to 15mg. Halfway between my last dose and my new dose. I slept much worse again, but woke up with a clearer head. I emailed Dr G’s secretary with a message for her, explaining what had happened on Saturday and how I’d felt. I said I didn’t know if it was the Nitrazepam or just a natural swing, but that I would continue to take the reduced dose unless she suggested otherwise. She agreed to that.

I haven’t been sleeping well. I do not see much point me being on sleeping tablets when I still take ages to get to sleep, wake up in the middle of the night for a few hours and struggle with frequent waking and disturbing dreams. 10mg of Nitrazepam is meant to be the highest dose and should cause me to sleep for hours and still feel drowsy the next day. It just doesn’t. Even the 20mg dose didn’t have much of an effect on my sleep.

I don’t seem to respond to sedatives much at all. Zopiclone didn’t do much and makes me hallucinate and for that reason I haven’t been given Zolpidem. Promethezine Hydrochloride, Promazine, Diazepam, Nitrazepam all have had little effect. Quetiapine didn’t sedate me at all, even on 500mg. Depakote did have some effect, but generally just slowed me down all day rather than making me sleep. Only Haloperidol has successfully resulted in sleep, but even that included frequent waking and the subsequent hangover and drowsiness lasted all day.

I wonder if Dr G will find anything else to try. She goes through her psychotropic drugs handbook regularly under insomnia and never really finds a new solution. Melatonin was mentioned and may be the next attempt, but we shall see. She also suggested Temazepam but then prescribed Nitrazepam instead. Something I think she may be regretting. It all could have been very nasty indeed on Saturday if I wasn’t kept safe.

Also on Monday, my CMHT social worker came to visit. I hadn’t seen her for two weeks as she had been on holiday. We talked about what had happened on Saturday and I explained I’d contact Dr G about it. She didn’t seem too bothered. We spent the rest of the appointment talking about things that I spend my time doing. She seemed keen to get me to go to the cinema or swimming and spent far too long labouring the point. I know I have to try and find pleasurable activities, but when you find no pleasure in anything it is difficult. I remember her trying to explain a cycle of depression and how the way to break the cycle is to change our behaviour using CBT methods, but she didn’t have a clue about how the CBT model worked or much else for that matter. It turned into me explaining The Priory CBT model to her as she attempted to patronise and bluff her way through it. She kept saying how she’s only a lay person and doesn’t know much about psychiatry. I found this alarming when she is meant to be my first point of call on all things mental health. Why oh why do I not have a CPN? I keep wondering if it is too early to ask for someone else? I don’t like her, find her patronising and her lack of knowledge scary.

She was also meant to be reviewing what services to refer me to, but had forgotten and didn’t have any of the information. Surely I should be referred to these services asap as I’ll be waiting long enough as it is?! She said she’d put some info about other services in the post for me to look at so we can discuss next time, but I still haven’t got anything. She also asked if I’d got an appointment with the consultant yet, but I still haven’t. She was meant to have chased that up but hadn’t done.  No appointment and no information. The other thing she was meant to have done was refer me to some telephone support service that I can’t remember the name of. They were meant to call me when she had, but she clearly hasn’t done that either. Chocolate teapot comes to mind. A different one to Kate and Chouette’s though! Thankfully I don’t see her again for another three weeks.

Since Monday I’ve just been feeling generally low. Tuesday night was jovial, as we had our Ladies Circle meeting. I am always cheery when there, but it is only holding the mood back for a couple of hours, assisted in my act by alcohol. I suspect people find it hard to equate how I come across there, with the openly manic depressive person most of them know me to be. I’ve been open with the group about my mental health as they all know I’m on long-term sick. They probably wonder what, if anything is really wrong with me, but I can’t help the front. It’s second nature when with people I don’t know very well.

This morning I was left on my own for a short while whilst my partner went to do a couple hours work for his old company. Thoughts were running rife, but I kept them at bay. I am low, but managing to stay safe. I am just frustrated that I still don’t want to be managing. I know I should stay safe, but my thinking is still distorted enough not to want to. I have the insight to know this, yet still don’t want to and don’t know how to change it. It’s a trap I am caught in and I know it has to change, but when and how, I don’t know.

Anyway, I’ve rambled long enough. I hope everyone out there is okay. The madosphere is quiet, but then I guess it is summer. People are on holiday.

I see others are moving on or posting less. Paranoia about anonymity seems rife. I think it’s a shame, but understand why. I hope people can continue to blog safely elsewhere or are happy outside of the blogging world.

I’ve actually considered giving up on anonymity here recently. I’ve even mentioned my first name on one of my posts, although hidden. If anyone that knew me found this blog they would instantly recognise it as me. I think it’s important more people are open about mental illness and I have been trying to be a lot more open elsewhere, but here I am hiding behind a pseudonym. Maybe it is time for that to change. We will see anyway. I still worry about my future, employment and reputation and don’t want my moaning here to jeopardise that.

As an aside – what a lot of tags I’ve stuck on this post! Blimey!

More Evidence…

Some of you may remember my post on Trichotillomania which I made a couple of weeks ago. In it I referred to this BBC article which mentions some research into the use of N-acetylcysteine (NAC) for the treatment of Trich. Today I saw Dr G and towards the end of the appointment my bloke mentioned the article and I explained it to her. I couldn’t remember the name of the drug involved, so she asked me to check and let her know. She hadn’t heard the news story herself, but was interested to know more and was happy to check if it will interact with any of my other drugs before I can give it a go. Dr G is quite progressive and innovative with what she prescribes anyway. She won’t always wait for things to become proven and approved before she prescribes something. She also mentioned a new drug, for which I could spot a leaflet about on her desk, that is meant to be good for sleep, but it’s also an antidepressant and she’s scared of the effect this may have being bipolar and my past experience of antidepressants. She said research is currently being done, but this one she didn’t want to risk.

Anyway, whilst I was looking up the name of the drug concerned in this article, I did a little bit of research and stumbled over the fact it had also been connected to improving residual depression in bipolar. Someone has done a some research into this and the paper was published last September. This article sums up the findings. If this really is the case, then there are two reasons for me to be taking it. I am certainly willing to give it a go. It’s a proven drug for other things, so should be safe and even if it isn’t, do I really care? Maybe that is flippant of me and my partner will be horrified to read it, but I really don’t worry about such things anymore. I guess that is the suicidal thinking that undermines everything. I should be thinking about this positively though and my willingness to try anything is the part of me that just wants to get better and doesn’t care how I do it.

For a change, Dr G was running on time. My therapist, M however wasn’t. With that in mind, we got started and did a quick meds review initially. The expected increase in Lamotrigine happened and an increase in the Nitrazepam too. I could do this prescribing lark myself these days! In two weeks time we shall do the increase again and I will then be on the 200mg she’s aiming for.

We talked about how things over the past few weeks seem to be showing signs of stabilisation and improvement. This is true but I say it with caution. In the past three weeks I’ve gone from rapid cycling every day or two between an almost okay mood and a horrifically suicidal one. This was followed by a week of consistant suicidal depression and generally feeling awful. Then over the last couple of days I’ve kinda felt depressed but getting closer to okay mood. The suicidal thoughts are still there, they never go away, but things are quieter.

The thing is, I don’t trust the cycles to not come back. My mood sometimes settles down and then the swings come back with avengence and I am up and down like a yo-yo again.  I also don’t trust the curve on the mood graph to continue rising. It has only been a couple of days of slightly improved mood and I’ve had that before. The bubble bursts as quickly as it forms.

Dr G is hoping that things are stabilising. Last week was stable but hell. If things stick like that it just isn’t going to work. I will get frustrated and then fall off a cliff, which is similar to what happened last January/February. She knows this and I think is as worried about it as I am, but I guess neither of us knows what to do about it. We just have to try and hope that this mood holds out.

M turned up and we talked a bit about what we’d said last week. Dr G was meant to have another appointment with the four of us there last week; Her, M, my bloke and me. At least that’s what three of us thought. Dr G was at her daughter’s graduation and had somehow double booked herself. The three of us carried on and had a session anyway talking about some of the relationship issues we’ve been having and communication. It is a topic that always comes up but an issue that doesn’t go away. Again the solution seemed to be to wait a few months and try not to think about it. Easier said, but they aren’t living with the torment all the time.

The rest of the appointment consisted of lots of ums and ahs whilst I grappled for something I felt comfortable to talk about. I generally failed until the mention of that article came up.

The previous couple of days have been spent at my grandparents. I hadn’t seen them since March last year, when it was my great grandma’s funeral. It was good I guess to see them although always a bit surreal and slow. It always feels like a bit of an act at the best of times, but even more so at the moment. I also saw my two cousins on that side of the family. H, the youngest, loved our puppy. My animal-mad aunt did too for that matter.

The future holds very little at the moment. I don’t know what to do with myself and that is scary. I have a lot of uncertainties and I want answers. I see my worker on Monday and Dr G in a couple of weeks. Aside from that, who knows?

Trying to talk…

I have struggled to write this week. I have sat and stared at the screen many times, but failed to pull anything together.

Twice this week I’ve brought up the problems that I mentioned in this post (basically thinking about splitting up with my bloke but feeling that I can’t for various reasons) with professionals and both times I found little solace or support. I tried to convey just how much distress this is causing me, but I seemed to fail. It’s frustrating when you are expected to talk to people about things, yet when you do you get little in return. I need to work this out in my head, but feel stuck. The thoughts are feeding my feeling of hopelessness and of course that only encourages the negative thoughts. It is making me worse yet it seems to be seen as a distraction and not worth talking about.

The first person to fail to help was my CMHT worker who I saw on Monday. I tried to talk to her but found it really difficult. She kept trying to use the “think positively” stick and didn’t seem to want to listen. She also tried to explain to me the effects of mental illness a million times. As if I don’t know them already! I hate being patronised. Generally the whole conversation was awkward. I hope things improve or there’s no way I’m going to be able to work with her long term.

Then on Tuesday I saw my therapist at The Priory. She also failed to grasp how much I am struggling. It was our last session so she was keen not to talk about new topics. It didn’t seem to occur to her that I’d have liked to use the session to help rather than just talk about superficial things. I guess she didn’t want to leave me stranded if we didn’t cover everything.  I don’t know how I feel about it being our last session. I don’t know how useful the sessions have been, but it was always something in my calendar each week. A constant in a world of uncertainty.

Today has been my last day of day care at The Priory. It hasn’t hit me yet but I am going to miss it. I’ve been going for therapy there since October and it has been a big part of my life. I’ve spent over 3 months living there!. I will be back a couple of times yet to see Dr G, but other than that it’s all over. I will miss the empathy and support you get there. I will miss the time out to think. I will miss the food. It is going to be a big loss and I’m not sure how I will deal with it. I know I will have to leave sometime, but I wish I was leaving through choice and because things were on the up, not because of money and NHS politics.

I think I’m going to have to give up now. I can’t write right now. My head is in pieces.

Not so good…

I’m not so good at the moment. I can feel the suicidality brewing and I don’t feel able to, or particularly want to stop it. I can’t stop thinking about it. I can’t remember when I was not suicidal and sometimes that makes it hard to take myself seriously, but I can feel it getting closer. I know I should be shouting up and I guess here I am, but I don’t want to. I don’t want anyone to stop me. I am fed up of being kept safe.

On top of that, my relationship is in tatters. I have been struggling for a while. I am out of control and trying to destroy everything we once had.

We’ve been together six and a half years so this is not a small thing. We are engaged and we’ve been through a lot together. There should be so much holding our relationship together yet I find myself wanting to tear it apart.

It is all my fault. It is me that feels I can’t live with anyone else. It is me that screams for independence. It is me that wants to isolate myself from those that love me. It is me that cannot feel love for anyone or anything. It is me that doesn’t care. It is me that is heartless and selfish. I hate myself for this.

I don’t know why I want to throw everything away. I just don’t feel comfortable in this relationship any more. I find myself feeling trapped and controlled. I question my feelings. I don’t know whether I love him any more. I don’t know if that is depression making it hard for me to love or care for anything or if it is really how I feel. It is a constant battle in my head.

I’ve gone as far as telling my bloke that I want us to break up. I don’t know if it’s the right decision but it’s what my head wants most at the moment. I know I shouldn’t be saying this if I am not sure, but I can’t help it. I have screamed it in fits of anger and irritation and I have repeated it during quieter moments. Saying it though is different to doing it. We are still together.

I don’t really have a choice at the moment. I have to stay. I have been told by Dr G that now is not the time for life changing decisions. I am not well enough to make an informed decision. I am told that things will probably improve when I’m better. I am told that I can always make the decision then if they don’t. I know this, yet I still find myself screaming to get out now.

I also don’t have a choice because I am trapped by fear of section. My partner has already told me that if I dumped him and tried to move out he would get me sectioned. He doesn’t trust me to live alone and refuses to let me break up with him just to make it easier for me to kill myself. I don’t see how it would be any of his business if we were no longer together, but I guess he still cares. It leaves me scared enough to stay.

There are other things that make me hold back. I fear the embarrassment of a failed engagement. I don’t want to admit that things are not good. I don’t want to admit that I was wrong. I don’t want to give in to those that said I was too young. I also fear my parents’ reaction. I don’t want to let them down.

Then there are the practicalities. We live together and splitting up would not be easy. Our lives are entwined. We have so much stuff together. We share the same friends. We have the dog and the guinea pigs. I wouldn’t know where to start if we had to separate ourselves.

My partner doesn’t know how to react. I know this is understandable. He loves me and doesn’t want to lose me. I tell him how I feel and he won’t listen to me. One minute he is angry with me and throws abuse. The next he tells me how much he loves me. We keep arguing about it. It’s painful.

I find myself getting upset when I think about the relationship ending. I wonder if that is a sign that it should continue. I don’t know. I know he still loves me and for that I feel guilty. The guilt is painful and maybe that brings the tears. I think it is loss though that really makes me sad. Loss of what was once there. I did love him once. I just don’t know if I still do.

For now we carry on as if none of this is really happening. It is a battle within my head. I don’t know what will happen. My bloke may eventually break and realise he doesn’t want me either. I may change my mind and realise I love him after all. We may just carry on in a broken relationship forever, neither of us able to leave. Something needs to happen though because the current situation is no fun.

Trichotillomania…

This is interesting. I have pulled my hair for so long I can’t remember not doing it. It’s something I’ve always been ashamed of, but don’t seem able to stop. My partner can never understand why I do it even when he tells me not to. It is something that gets worse when I’m stressed or feeling low, but is such an ingrained habit it is there when I’m well too. I really do wonder if there is a magic pill that could stop me and if so, why haven’t I been given it yet?

Aside from that, today I saw Dr G with my bloke and therapist. It was strange having the four of us in Dr G’s little room. I felt quite intimidated and overwhelmed and it didn’t take me long to start crying from the stress of it all. We talked about how I need to be more open about things, something that has been repeatedly a topic for discussion, but something I find very difficult. I often think I don’t want to be open and honest about how I feel. I don’t want people to panic and I don’t want to be helped. If you’re feeling really suicidal, the last thing you want is everyone to know so they can stop you. I don’t see how I can break that barrier to openness.

Yesterday I finally met my CMHT worker, J. She’s a social worker, not a CPN, which I’m slightly disappointed about. I have been told they don’t distinguish between them in our trust, but I somehow think a CPN would be more use. They’d have more understanding of my illness and what it really entails. We chatted about my life and the past year as she wants to get to know me. I don’t know if what I said was helpful but the time raced by. I wanted to ask what is going to happen to me but she didn’t seem to know. She was surprised that I hadn’t yet had been sent an appointment with the consultant so is going to chase that up. I am not sure her coming to see me is going to be that helpful but we will see. I might be able to talk to her properly eventually. I found I was being economical with the truth when she asked me how I was feeling. I couldn’t help it. I don’t yet trust her. I see her again next week.

I am seeing Dr G again on Thursday as she didn’t have time to do a medication review today. She said she’d review my sleep again, which has gone haywire since coming off the Haloperidol. I’m a little more awake during the day but not sleeping much at night. Temazepam was suggested so we shall see what she comes up with. I’m sure the Lamotrigine will go up again too. She has to titrate it up so very slowly. It’s hard being patient waiting for the increases. I just want her to stick it up to a high dose and be done with it, but I know she can’t.

Generally I feel a little empty and numb. I am just carrying on because I have no choice, but it’s hard. I don’t want to.

Strange Appointment…

Today I saw Dr G. It was slightly weird. She talked about her thoughts after meeting my Mum and Dad last week. She asked me if I thought my mum has problems too and I had to admit I thought she did, even if I know my mum would never admit it or seek help for them. She wanted to talk about how my mum’s inability to connect emotionally may have affected me as a child. It’s something I have thought about myself, but I don’t have any answers. Dr G is a psychotherapist as well as a psychiatrist so she had her psychoanalytical hat on. It was weird to hear her thoughts on the subject and it was clear she thought my mum had real difficulties emotionally and more importantly that her inability to show her emotions to me may have contributed to my problems now. She even suggested that my mum may have asperger’s syndrome, which was quite surprising. It seemed amazing that Dr G could suggest that having only met my mum for a few minutes and knowing what I’ve said about her, but reading up on it since, I think she may be right.

The thing is, I don’t know where this leaves me. It’s true that it probably had some impact on me growing up and may be another thing that has contributed to how things are, but I don’t see how thinking about this now will make my illness go away. It’s strange. I just don’t know how to react. I didn’t really know what to say when Dr G was talking to me about this. She still agrees that I have bipolar disorder and that my depression and mood swings are probably chemical, but she also thinks that this may be an added issue that I need to deal with. How I deal with it is an entirely different story and I don’t think she has the answer either.

We also talked about more comfortable topics such as medication. She wants me to come off the Haloperidol as it was only meant to be a temporary measure to combat the racing thoughts, agitation and hypomania of a few weeks ago. I’m apprehensive about stopping it as I don’t want to become agitated again and I am worried the insomnia will creep back. I am fed up of the constant sleepiness that the Haloperidol gives me, but it’s preferable to a mixed state any day. We shall see I guess.

In other news, my CPN was meant to come and see me yesterday for the first time but she cancelled. This means I am now seeing her on Monday. I was apprehensive so was a little annoyed when I got a phone call a couple of hours before saying she couldn’t come. It makes me feel as if I’m not important and makes me worry about the amount of support I am going to get going forward. The NHS really is crap.

Glastonbury…

Yes, I return. I’ve spent the last week in the never, never land that is Glastonbury Festival and I’m back and exhausted.

Aethelread suggests that it wasn’t the best Glastonbury and I have to agree with him. However, my complaints weren’t with the headliners or lack of diversity in the crowd, more my state of mind and inability to enjoy anything. I spent most of the weekend unable to cope with the crowds, moaning about everything and not being able to let go and enjoy things.

I regret it all now. Watching back highlights I realise what I missed out on. I didn’t make the most of this year at all. I should have tried to forget everything and enjoy the freedom that Glastonbury gives you. I should have let go and just ignored how crap I felt and made the most of it. I should have tolerated the tiredness, my aching limbs and stuck it out. I should have put up with the crowds and not got panicky when I was unable to move for people.

I struggled all week though. I couldn’t cope with the crowds at all and felt myself getting anxious whenever I got stuck behind people and couldn’t move freely. Wednesday was so much busier than previous years and it sent me into a tailspin. I am used to a relaxed Wednesday with no one around. It was definitely a busier Glastonbury than the last two years and I couldn’t handle it all. I’m not sure if I just noticed the people more this year though because of everything that’s happened in the past year. I’ve definitely changed. I used to be at my most content at the front of a massive crowd at a gig. This year, I couldn’t cope with the dense crowds at all and opted for standing way back where I could still move a little.

I avoided the main stages wherever possible, only suffering the pyramid stage for Regina Spektor (my glasto highlight), Lily Allen and bits of Tom Jones and Blur. I spent most of my weekend in the Cabaret tent watching comedy, where it was quiet and you could find a nice spot to sit down. I also spent quite a bit of time wandering the green fields and not enough time actually seeing bands.

I also spent a great deal of time sleeping. I kept falling asleep during the day whenever we sat down for a bit. I don’t know if it was the heat (it was sooo hot!) or my medication but I just could not stay awake. On the Tuesday night before we left and the Wednesday I had terrible insomnia and barely got any sleep. By the Friday I was exhausted and on both Friday and Saturday I was in my tent before the headliners had finished. It seems I go from one extreme to the other in more ways than just my mood.

Then there was the rain and the mud. Everyone seems to think it was a relatively dry glastonbury, but it seems the TV coverage failed to mention the torrential rain on Thursday/Friday and the fact it still turned to a mud bath in no time at all. It certainly wasn’t as bad as two years ago, but I still struggled with the rain. I just hid under our gazebo. It rained really badly on Sunday night too, just as we were about to embark on the walk from site to our car. I was drenched in seconds!

Generally the line up wasn’t that strong this year either. There was very little I actually wanted to see. It doesn’t matter. I don’t go to Glasto for the line up. I go because of everything else, but it is a bonus when the music is good too. There weren’t any real musical highlights this year. No moments that stood out as being truly amazing.

In general, the whole experience seemed a little flat. I did enjoy some bits, but a lot of the time I actually didn’t want to be there at all. I wish I could enjoy things, but it seems even my favourite things have lost their shine.

Being back is difficult too. I don’t want to be back. I never wanted to come home from this Glastonbury. It had been a goal in the distance for quite some time and a reason to stick around and now that it’s over I don’t know if I want to continue. It feels like I don’t really have much else to stick around for now.