Into the system…

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Archive for April 2010

More of the same…

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It’s been a while since I’ve blogged. I guess there isn’t all that much to say at the moment and I’ve been so busy with day to day stuff.

Generally my mood has been reasonable. I think I am “recovering”.

There are times when I pretty much feel “normal” now. I don’t really notice anything mood-wise, either bad or good, which I guess means things are fine. I am busy doing things and life goes on without too much fuss or strain.

I’m still getting dodgy days. Days when I realise things aren’t quite right or my mood is a little down. Days when I feel crap and want to hide in bed or when I am grumpy and irritable., but these days are generally manageable and usually roughly within the realms of “normal”.

I keep having to tell myself that even the non-mentally-ill have bad days and it is to be expected. I think I realise I’m still recovering and not completely better yet. My bloke seems to be having a fair few bad days himself at the moment! It feels a bit weird being the happier, less grumpy one out of the two of us.

I would say there has been one, maybe two days when things haven’t been good at all and I’ve worried that things are slipping or haven’t changed and that maybe I’ve been deluding myself. I am worried one of these days may push me to do something stupid, but I hope not and don’t think they will. I think I can cope with them, but it keeps reminding me that things aren’t quite “normal” yet.

I forgot to take my meds properly a couple of times over the weekend and I certainly noticed it, both mentally and physically. I could feel my mood drop and depressive thoughts creeping in, but realising I’d forgotten my meds put my mind at rest a little. I noticed the physical effects too – I felt a bit dodgy at the time, but since I’ve noticed the side effects from the Reboxetine are stronger again too – the overheating and sweating, the nausea. My appetite had been creeping back though, so maybe skipping my meds every now again will keep it down. Hmm, perhaps not such a good idea.

I was pretty surprised that missing a couple of pills had an effect so quickly though. When I stopped my Lamotrigine back in November I didn’t really notice anything, but I guess it is different with the Reboxetine. It has a short half-life and is meant to be relatively quick-acting, so I guess it makes more of a difference. I don’t like the idea though that just missing a couple of pills makes me feel so much worse and could be enough to push my mood back into relapse territory. I don’t like that my mental-health is in such a fine balance.

I saw Dr M yesterday. It was a fairly pointless appointment. Talked about what I’d been up to over the past 6 weeks, my improvement in mood, side effects, me and the bloke, life in general. Nothing very exciting really.

She wanted to do something to tackle the insomnia, but of course discussing medication we came up against the same thing we always do. I’ve tried pretty much tried all the main sleepers and none have helped. She suggested I try some Nytol, so I guess I should probably try that.

She had planned to increase the Reboxetine, but decided she would like to wait. She seemed to think that things had improved quicker than she’d expected and that maybe I won’t need a higher dose, but she said we’d see. Wants me to see how the next 6 weeks go and then she’ll decide. If my mood tapers off a bit or has plateaued too much then she will push it up again. I was kinda disappointed that she didn’t do this anyway. Although there has been a big improvement, there are enough of the dodgy days to give me concern and there have been more in the past fortnight than there were a month ago. We shall see.

I was going to write about life stuff too, but I’ve got a headache and I am tempted to rest. I shall give you a list of things in brief!

Over the past couple of weeks I have been busy…

  • Doing lots of stuff for the Youth & Community Centre that I’m on the committee for: press releases, survey design and other bits and pieces. It’s very much like work and has been taking up a lot of my time. I am still pretty slow at getting things done and my confidence isn’t brilliant, so I end up checking everything a million times. I was getting pretty frustrated as it felt like no one was listening to me, but I’ve managed to get most things done now. It is probably good preparation for me trying to return to work though. Not sure what I will do when I go back though with regards to all my voluntary activities.
  • BBQing. We had some friends over on Grand National day for a BBQ. We had a big dog over to visit. He’s a Scottish Deerhound and he’s lovely. Our doggy is besotted. There were also small children and lots of adults, so it was a little chaotic having two massive dogs running around too. Funny though.
  • Visting Em. Went over to see her when she was in hospital a couple of weeks ago. It was lovely to see her, but she did look pretty poorly. :( Sad to hear that she is back in again too. I was going to visit her again, but as she’s got a nasty infection (MRSA :S), I’m not sure it’s such a good idea. Hopefully she recovers soon!
  • Reading. After seeing The Girl With the Dragon Tattoo at the cinema, I’ve started on the books. Finished the first two of the millennium trilogy and started the third yesterday and already nearly half way through. I guess this shows my concentration has improved quite a lot as there is no way I’d have been able to get through 2 and a half 600+ page books a few months ago.
  • Camping. We went to Lincolnshire for a few days and a friend, M came along too. Doggy loves camping. It’s a great big outdoor adventure and she gets plenty of walkies. We went to Sandringham to see the queen (not that she was in!), had a couple BBQs, went to the beach and watched Boston United play FC United of Manchester which was interesting. I felt too sick (after too much cider the night before) to go up Boston Stump, but M and my bloke did and from the pics, it looks like there’s a pretty impressive view.
  • We went up to Northumberland over the weekend. Stayed in a hotel not far from Morpeth. The bloke grew up there, so we met up with some of his friends on Saturday night. We also went to the beach, wandered around Newcastle and went over to Cragside whilst we were there. I love the North East. Doggy was in kennels as we didn’t know what we’d be doing, but I felt quite bad as she would have loved it. She seems to quite like her kennels though.

Think that’s the bulk of it.

Anyway.. I have doggy biscuits to bake, a doggy to walk, dinner to cook and probably a million and one other things I could be doing… I really just want to curl up in bed with my book or to sleep. bah.

Good days, Bad days…

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I’ve had a lot of good days lately. My mood has picked up sufficiently that I am feeling almost “normal” at times now and certainly manageable at others. I have actually felt happiness or contentedness, something I wasn’t really sure was possible any more. My concentration has been improving and my confidence is growing.

I have started to contemplate the idea that I may finally be heading towards some form of recovery. Maybe, just maybe, we have found the drug that works, despite the problematic side effects.

I have been foolish though in thinking the bad days had passed. I had hoped that I wouldn’t feel that bad again, at least any time soon. I really didn’t feel good yesterday. I woke up feeling low and felt worse as the morning went on. For the first time in a while I felt seriously suicidal, as opposed to the passing thoughts that had been floating around, but which I could brush off relatively easily. I was having to really fight the urge to just thrown in the towel. I felt anxious and uneasy. I’ve been struggling with strange dreams and nightmares lately and they were bothering me. Everything just felt wrong somehow. I wanted to crawl back in to bed and hide there. It felt like nothing had changed. I thought I was past all that, but I was wrong.

Things did start to improve again yesterday evening, but I am feeling a little shaky still. I feel like I’ve been knocked off balance and I’m struggling to right myself.

I am trying to tell myself that this is normal, recovery isn’t a smooth process and bad days are to be expected, but it doesn’t ease the disappointment. Telling myself this didn’t make yesterday any easier.

I hope that things will pick up again, but I am worried that this will set me back. One of the things I struggle most with is the idea that I will never be completely well again and there is always a fear of relapse. A bad day is like a mini relapse and it makes me question if it is all worth it. What is the point in carrying on, if in 6 months, a year, 20 years I end up severely depressed again and try to kill myself? My thinking may be screwed up, but I just wonder if I may as well get it over with.

I had been thinking about going back to work. I do miss it and I’ve been missing it even more when I’ve felt okay. I wonder why I am not there. I know I have only just seen Occy Health and I agree that I’m probably not ready to go back just yet, but I was starting to think that I will be able to do it. Even 3 or 4 weeks ago when I was there, I doubted it would ever be possible. A run of good days has made me think it is, but this bad one has put the doubt back. I worry that it would only take a couple of bad days at work and I would be back where I was before.

I’m still really struggling with the future. I panic when I think about what lies ahead. I am scared of therapy. I am scared of going back to work. I am scared that I will relapse. I am scared of commitment in all shapes and forms. I am scared of getting married. I am scared of buying a house. I am scared of getting old.

I am frustrated, because I was meant to be seeing Dr M on Thursday and I got a phone call today to say she has cancelled. I am disappointed, as after yesterday I felt I could really do with seeing her again soon. I wanted to discuss the Reboxetine. I think it is time to increase it to the “therapeutic dose” (4mg b.d.). I hope that those extra 2mgs will be enough to stave off the bad days. I just hope it isn’t enough to tip the side effects into not-worth-it territory. She was also going to discuss what we can do to ease the side effects, particularly looking at sleep again – the insomnia is the biggest problem. I quite wanted to know what ideas she had come up with since I’d last seen her.

I now have to wait another 2 weeks. It is going to end up being 6 weeks between appointments by the time I eventually see her and we were aiming for every 2-3 weeks, so that’s not so good. It may still be better than the CMHT, but I could have done with seeing her sooner.

I guess I will just have to manage how I am. We will see what happens. I’d like some more good days.

Reboxetine…

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I’ve been taking Reboxetine for a couple of months now. I started on a stupidly low dose and even with that I started to struggle with side effects. It has been increased a couple of times now and the side effects are a nightmare… BUT I THINK IT IS WORKING!

Reboxetine is meant to be taken in divided doses; 4mg morning, 4 mg at night, but I haven’t even got that far yet because of the side effects. One of the biggest problems is insomnia. I started on 2mg in the morning which wasn’t so bad, but then they needed to add the night time dose and that pretty much stopped me sleeping at all. I couldn’t even tolerate taking 2mg at night without it keeping me awake. So they decided to move the full 4mg dose to the morning, which was a little better. I still wasn’t sleeping very well (around 4 hours a night), but it didn’t seem to make things much worse than normal.

The dose was increased though about 3 weeks ago and we now have a problem. I can’t really take a larger dose all at once because Reboxetine has a fairly short half life and wears off pretty quickly. It was suggested I took 4mg in the morning and 2mg at lunchtime. The problem with the lunchtime dose is I often forget. If I’m out and about I don’t normally remember to take it with me or even if I’m home I keep telling myself I’ll go take it and never do. If I end up taking it mid-afternoon or evening I have a nightmare trying to get to sleep. If I take it late at night I usually get to sleep initially, but wake up an hour or two later and spend the rest of the night awake. Even if I take it at the right time I still have a problem sleeping. The only time I seem to be able to sleep properly is around 7am-10am in the morning when the meds have worn off, when ideally I should be getting up. I am struggling with the lack of sleep and I’m pretty sure it isn’t helping ease my headaches.

Aside from the insomnia there is a plethora of other side effects to contend with:

Sweats are a big problem and at times I get so hot I seem to start shaking or I feel faint and dizzy. This happens even when it is really cold outside and I’m wearing short sleeves. I must look ridiculous going around in short sleeves when everyone else is wrapped up in coats and scarves. I end up carrying my coat around everywhere because I can’t bear to wear it, but that means I get wet!

The Reboxetine has killed my appetite too. At the moment it is not unusual for me to eat nothing all day, for my bloke to cook me dinner and for me to eat half of it and then give up. The only thing I seem to want to eat is sugar. Everything else makes me feel sick, especially chicken for some reason. I don’t know if that has something to do with the fact I spent a weekend throwing up a couple weeks ago and one of the things I’d eaten was a chicken slice, but it’s a little annoying. I’m fed up of the nausea. It does have an upside though. I have lost a bit of weight over the past couple of weeks, although I’m sure if I wasn’t just eating sweet things then I probably would have lost more. I may be eating less than normal, but I think I probably eat healthier than this usually.

I am still getting the occasional attack of upper abdomen/chest pain too. It was assumed this was down to acid reflux and it does seem to have eased off over the past couple of weeks, so maybe the omeprazole has helped on that front. I just hope it doesn’t get worse now that I’ve completed the course of meds.

Add the common medication annoyances of constipation and dry mouth to the list and you have a pretty comprehensive list of side effects. The stuff is making me feel pretty rubbish, on the physical side at least.

The side effects do seem to ease off a little when my body has had a chance to get used to the dose, but it is really not fun in the meantime. Dr M is pretty concerned about the side effects too. She has been reluctant to increase the dose each time I’ve seen her, although she knows she needs to. I’m not even on the recommended dose yet (4mg b.d.) and she thinks I will probably need a high dose eventually, so that means I’ve got a few more of these increases to tolerate. I hope that by persevering the worst will pass, but I know that every time the dose is increased again, all the nasty side effects will be back worse than ever. I don’t know if I can handle it getting any worse. I almost wonder if she should just stick the dose up to full strength and see what happens. I think I’d rather feel absolutely dreadful for a couple of weeks, rather than pretty rubbish for a couple of months. I just don’t know if I’d tolerate it or not.

Dr M even seems to be considering taking me off the Reboxetine because of the side effects, but I am loathe to give up on it yet. I can feel it improving my mood and that is a big thing for me. It is the only antidepressant to have done that without sending me completely doolally. I have tried so many different antidepressants and other medications that I had kinda given up on the idea that I’d ever find something to lift my mood. This has changed that. I now have some hope that medication may eventually help me.

I hate though that I find something that may actually help my mind and my sodding body won’t tolerate it. If I find something my body can tolerate, it does nothing for my mind. Why can’t I have both? There must be some meds out there that will work and not make me feel ill?

So, yes. The side effects may be doom and gloom, but I do think it is working. My concentration is improving and I feel able to do more. I don’t actually mind getting up in the morning now. I may be knackered from the lack of sleep, but at least when I wake up I am not filled with this absolute dread of facing another day. It may sound clichéd, but I feel a little lighter. I don’t feel like I am being crushed by this overwhelming sadness any more. Things are by no means fixed, but they are definitely better than they were.

The intrusive thoughts are less and have changed too. I sadly can’t report that the suicidal thoughts are completely gone, but they are different and less often. Before, I had reached a point where I was absolutely certain that death was the only sensible option. It was all that I could think about and it didn’t matter what I was doing or how busy I was, it would be in my mind and it was the ultimate goal. I wanted to die and I spent all day thinking about how I was going to do it as quickly and painlessly as possible.

I am not certain any more though. I still find life and the future pretty hard to comprehend, but I don’t see suicide as inevitable now. I am still struggling to resist the urge to just give up on everything, but I haven’t already given up. The thoughts are mainly impulsive ones now, rather than the pervasive ones that were there before. Generally, the thoughts are kept at bay when I am busy and they only really hit me when I am anxious or upset, or at night when I am struggling to sleep and have time to think. I am keeping myself busy to push the thoughts back, but I can’t do that forever.

When I do stop to think, I am scared. I am scared that it won’t take much to push me back down the slope. What if I have to stop taking the Reboxetine because of the side effects? Will I get worse again? What if I don’t keep getting better? Will I give up again in frustration? What if I just give in to the impulsive thoughts that linger? What if, what if, what if?

I am scared by the thought of recovery. I am frightened by the future. I have spent so long assuming there is no future, it is impossible to know what to do with one. I don’t know how to live my life if I actually get it back. Dr M and New Social Worker ask me what I want to happen in a month, 6 months, a year’s time and I have no idea. I have no real aspirations because I have given up on them all.

I wrote about wanting to go back to work, but I am not sure I can actually do it. It is too hard to comprehend. I have been off for so long I don’t know if I can remember what it is like to work. Illness, ECT and medication have all messed with my brain and I don’t even know if it functions enough for me to work anymore. I feel so stupid and slow these days.

I am worried that I am not strong enough to recover. I am scared of therapy. I worry that it will make me so much worse in the short term that I won’t be able to cope. I don’t even know what it is meant to achieve. If my mood is improving with the medication, maybe it is more down to chemicals than Dr M is willing to admit? I know there are other problems, but I don’t know how therapy is going to help. I don’t even know if or when it will ever happen. I’ve been waiting so long it is pretty hard to imagine ever coming to the top of the list!

I feel like a coward. It seems so much easier to just give into the suicidal thoughts even now. I know things are improving, but I am too scared of what lies ahead. I have got so used to the idea of suicide that it is almost comforting. It is strange. Suicide is a coping method, as much as a get out clause.

I know I just have to face it. I know I need to stop worrying and thinking about it, but I can’t help it. I guess everyone facing the idea of recovery has these thoughts. I have been trying to ignore them, but they have been niggling away at me.

I have to fight these thoughts. They fuel the negative and intrusive thoughts that linger. I am trying.

Written by intothesystem

Thursday, 1st April 2010 at 9:25 pm

Argh! So Busy…

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I really am so busy at the moment. I have a list of 101 things I need or want to do and although I seem to be doing lots, the list isn’t getting any shorter. I feel a little like I’m drowning in it all, but I am trying to keep going.

I’ve been at various appointments over the past couple of weeks (Occy Health, Dr M, Dr N, New Social Worker etc). We took our dog to Crufts a couple of weeks back. We had the Creative Remedies exhibition launch last week and I was busy getting things ready for that. We’ve had a couple of circle meetings. I’m on the committee for the local Youth & Community Centre, so have been doing bits and pieces for them. My little sister turned 21 last weekend, so we went home for the weekend. I’m helping get things ready for the event in the village on Easter Monday. It’s been a bit crazy really and there is plenty still to come.

The busyness is generally distracting me from how I am feeling. When I’ve seen Dr M and Dr N they ask me how I am and all I can say is “busy”. I feel pretty disconnected from my mood and emotions at the moment. I am too busy doing to think. I don’t know if that is a good thing or not. I guess at least it means that the blackness isn’t all encompassing at the moment. The thoughts are pushed back and less intrusive than they were.

If I do stop to think though, I feel a little overwhelmed and anxiety hits me. I’m worried I’m pushing myself too hard or taking on too much. I worry that things will fall apart or my mood will fall off a cliff and I will have to drop everything, letting loads of people down. I worry that I will give in to the impulsive thoughts and just give up on everything.

I also worry about things going the other way. I worry that if things improve and I get well enough to go back to work, I won’t have time for everything. I’m involved with loads of voluntary things at the moment and although I know I can’t do it all, I don’t want to stop doing them and I don’t want to let people down.

Back in December/January when I was planning my suicide attempt, I found that one thing which held me back was knowing that people were relying on me to do things and I didn’t want to let them down. It wasn’t enough to stop me, but it did make me think twice. I guess by committing to more things, I am putting up plenty of barriers to keep me here. I just hope it works that way and doesn’t have the opposite effect of overwhelming me and making me just give up.

I guess the fact I am hoping this will keep me here shows there has been an improvement over the past couple of months. I am not sure how much I truly hope, but I know a few months ago it was impossible for me to hope for life at all. All I hoped for was death and as fast as possible. I am not entirely sure what I want now, but life feels like an option again and that’s got to mean something.

This was going to be part of a much longer blog post, but it is long enough already and it may be better for me to stick to one topic per post. I have quite a lot to catch up on and it will be quicker if I do a bit at a time! So busy that I am finding it hard to find the time to write, even though I really want to.

Written by intothesystem

Thursday, 1st April 2010 at 8:33 pm