A little unstable…

I have been quiet over the past month or so. I keep thinking “oh, I really must get around to writing that post”, but it never seems to happen. I do start posts, but somehow they never get finished and by the time I get around to it they have become irrelevant and I end up having to start again. I guess if I started writing shorter posts, it might not take me so long to finish them!

My last proper post (excluding the 2010 review) was pretty negative, but an accurate reflection of my mood at the time. Things have improved a since then, although they still feel a bit shaky. I felt really really awful for a few weeks, but Christmas was bearable and I was able to keep going without slipping any further, so that is encouraging. If that is as low as I get, I can survive, but I don’t know how much lower I could go without ending up back where I was a year or more ago. There were definitely times when I didn’t think I’d make it to here, which was worrying – I’ve not felt like that for a while now, but it has passed now really.

Over the past week I have felt a little on the edge. Motivation has been somewhat lacking and I feel exhausted and low, yet there has been a strange bouncier edge to it too at times. Things don’t feel stable any more. 2010 was a year of relative stability. During summer things were pretty consistent and I felt quite well. Since autumn I’ve been consistently low, but mild depression is manageable. Now I’m all over the place. A few days feeling better, a few days feeling rubbish, one day where I feel all over the place, another where I feel strangely mixed, the occasional day when I just feel normal. There is no consistency at all anymore.

My sleep in particular is a mess. I really struggle to get up each morning and feel exhausted, but then I spend the late evenings trying to slow down my racing and flighty thoughts. I can’t seem to concentrate on any one topic but spend the night with random things darting around my mind. Even when I do sleep, my dreams jump about and I wake up frequently, often shaking or panicky. My dreams have been so weird it has been disturbing me. I find myself thinking about them in the day or unable to shake the uneasy feeling that goes with the nastier ones. Occasionally suicidal thoughts pop up and sometimes these thoughts can be so clear and urgent it can be scary, but there are also excitable flighty thoughts – plans about holidays, knitting, work etc, which would suggest a good mood. It feels slightly strange and can be somewhat frustrating when I can’t sleep, but it is preferable to feeling how I did before Christmas. I quite like the flighty-awake feeling and if I didn’t need the sleep I’d happily become nocturnal and make the most of it, but my body is really tired and I don’t want to keep the bloke and the dog up, so instead I lie in bed tossing and turning.

The last couple of days haven’t been so bad on the mood, but I have been struggling with nausea on and off. I’ve not been sick, but on Sunday night I felt awful. Being sick would have probably been a relief. Nausea does tend to calm down the flighty side of things as moving about just makes me feel worse. Not feeling too bad at the moment, but it seems to come and go.

I am hoping the recent instability can be put down to fiddling with the Reboxetine dose and not taking it consistently at the same time, but I’m not so sure. Things were going haywire before I started the dose experiment. I was told to try taking 8mg some days and 6mg on others to see if it helped with the side effects. I tried it for a bit over Christmas but I found it made the side effects worse than normal on the day I took 8mg and I didn’t feel much respite when taking the lower dose. I’ve also been struggling to get up, so was taking it later than normal, which definitely contributes to the insomnia at the other end of the day. I was trying to take a lower dose on those days, but that didn’t seem to help too much. Things are noticeably worse though if I take the full 8mg dose after about 11am. I’ve gone back to the full dose though and am taking it earlier again, so I hope that will help settle things down.

I saw Dr M on Friday. I mentioned all of this to her. The rapid decline in December, the slight improvement over Christmas and the up-and-downy-ness since. She seemed slightly surprised and a little concerned when I indicated how bad I felt in December, but relieved things have improved a bit since. She thinks I’m a lot stronger these days and that I will be able to manage things better even if I do get more depressed. I think she is probably right.

We discussed medication again. She does think something needs to be added to the Reboxetine. If we can boost the effectiveness of the Reboxetine then maybe I could drop the dose and reduce the impact of the side effects. She’s concerned about sleep too and wants something that will help on that front at the same time. Quetiapine was encouraged again, but I’m still not keen on the idea. It didn’t do anything helpful for me before and I doubt it will again now.

The other option was Mirtazapine. I’m not sure about this either, mainly because of the weight gain risk. I’ve lost a lot of weight over the past year and the last thing I want is to put all of that back on. Aside from that it could probably be a good option. It is meant to be sedating and also partly works on Noradrenaline, which should help. It has a longer half-life than Reboxetine, which could also help stabilise things.  I haven’t tried it before so it may be worth a try, especially as it can work when other drugs haven’t, but I’m not sure. I don’t know if it is worth the risk of it not working, although I guess if the side effects are bad I can always discontinue it. I think I’d also be slightly annoyed if it did work because Dr N and I considered it right at the start, but decided against it because of the weight gain risk. Imagine if it is the right drug and we’d chosen it right back then – maybe none of the past 2 years would have happened. Glorious hindsight. I am not sure though and the bloke is definitely not keen on the idea. He thinks I should just try and manage as I am and do what I can to boost the Reboxetine over the winter. Maybe he is right, but then again I don’t want to experience a sudden drop again like in December as if that happens maybe I won’t be able to manage.

I didn’t want to rush into any sudden decision with Dr M anyway, so she said she’d write to Dr N, tell him what she suggests and leave it up to us to make the decision. He can prescribe it if I decide to give it a try. I need to book an appointment to see him and see what he thinks. I think he would be pretty keen to get me off the Reboxetine if we found an alternative that didn’t send me mad, but it’s a risk and I don’t know if it may be better to wait and see.

Friday was also a year since I tried to freeze myself to death whilst overdosing (it sounds ludicrous to me now) landing myself in hospital for 5 weeks. It was weird to see Dr M almost a year on from when we first met and I mentioned this to her. We both commented on how much better things are now. Quite a lot has changed since then and I do wonder if her initial impression of me has changed. I realise now that I was delusional and paranoid at the time we met, as well as being suicidally depressed, but it still upsets me that my behaviour was put down to a disordered personality and not simply the fact I was somewhat mood-disordered and dealing with the after effects of an overdose. I was definitely not myself and I don’t know how anyone could take that first meeting as representative of my usual personality. I am still frustrated by the whole thing and find myself pondering over it again and again. I wonder if now is the time to challenge the whole diagnosis malarkey and find out what she thinks now she has had much longer to get to know me. I wanted to bring it up and I keep considering it, but I’m just too scared. I am terrified of being told they still feel I have a PD. At least before there was always that bit of doubt and a hope they would realise they were wrong. If I bring it up then I may have to face the fact that diagnosis is going to follow me around.

I’m not sure if I ever wrote about this before, but one of the main reasons I want to challenge the diagnosis again has come from the appointment I had with the locum GP a few months ago. When I was there, he looked back through my notes to find something. We were both watching the screen and as he scrolled through I could see that “Personality Disorder – NOS” was filled in the diagnosis box, visible in big bold letters. On some of the entries it didn’t even list “Recurrent Depressive Disorder”, which is meant to be my main diagnosis. In fact it is meant to be my only diagnosis, because I had been told that they wouldn’t give a proper diagnosis of a Personality Disorder unless the psychologist from psychotherapy (when I eventually start it) thinks I warrant it. I had assumed all mention of the dreaded diagnosis would be dropped until then. Apparently not.

So yes, this has concerned me and since then I have toyed with the idea of applying for my notes. I want to see what has been written about me, especially about diagnosis. I have been somewhat paranoid since. I worry about being seen as just another PD and that any physical problems are seen in this light. I worry that Dr N thinks I’m making things up. It has definitely damaged my relationship with Dr N, as I worry that he just sees me through PD disordered lenses and I don’t feel I can trust him as much anymore since finding out he has been using the PD as my diagnosis. I have found it a lot harder to talk to him since then. I have thought about bringing it up since that appointment, but the time passed and I think I missed my chance.

Another opportunity to bring it up may come up soon though. On Saturday I finally got my new assessment appointment date for psychotherapy. It has been nearly 18 months since I was referred. I have an assessment tomorrow with a clinical psychologist, HP. I hope it is less pointless than the last one, but I have no idea what I can say to her. I am worried about bringing up the diagnosis thing. I may just see if it happens. I don’t know what we are going to talk about though. I have no idea what may help or what I need to discuss. In general things are okay and the things that were identified long ago are no longer relevant. It is the more physical sides of depression that get me most these days. I’ve waited so long that I have to see what they can offer though. Maybe it will help in the long term. It may at least help to have somewhere to discuss how I’m feeling about work as I’m trying to get back. I’ve felt a bit on my own in that regard. Fingers crossed it goes okay anyway.

The other thing that Dr M brought up at the end of our appointment, was this blog. She asked if I was still writing. I admitted that I was, although a lot less often than I used to. I said that I keep wanting to write, but don’t often find the time. I go through fits and starts. She seemed to find my response interesting and seemed intrigued. I wondered if she would get curious and want to look at the blog since. I suspect she may have, as someone in the area visited the blog the day after my appointment. I don’t know whereabouts she lives in the area and I guess it could be anyone, but somehow I got a feeling it was her. I’d like to know if she has read it or not though.

So yeah, that was that. I have a lot half-written about work and more to say, but I will leave that for another post. No idea when I will write it though.

Reviewing 2010…

So everyone seems to be doing the New Years meme. I used to do this years ago back in the days when I wrote on Livejournal and I’ve copied the questions directly from the last time I did it on there (2007), so if it is different to the version everyone else in the madosphere has done, then that will be why. It is a bit weird to see these questions again.

1. What did you do in 2010 that you’d never done before?:

Take Reboxetine, Go InterRailing, Learn to Knit.

2. Did you keep your New Year’s resolutions, and will you make more for next year?:

I don’t usually make any and I can’t remember if I did last year. It seems unlikely because I was planning to kill myself on 7th January and any more resolutions would have been pointless. I tried and failed at that one.

This year, I haven’t set any firm resolutions, but most of my hopes evolve around recovery. I hope to get back to work full time and stay out of hospital.

3. Did anyone close to you give birth?:

Not that I’m aware of!

4. Did anyone close to you die?:

Thankfully not.

5. What countries did you visit?:

Oo. I went InterRailing so I have visited a few this year! I passed through France and visited Belgium, Germany, Poland and Austria.

6. What would you like to have in 2011 that you lacked in 2010?:

Proper recovery – I started to recover in 2010, but there’s still a long way to go. I want my life back.

I also want to move house, so a new home is pretty high on my list.

7. What dates from 2010 will remain etched upon your memory, and why?:

I don’t tend to remember dates very well and the only date that really comes to mind is the 7th Jan for the reason mentioned in answer to question 2.

I think the 29th July was the day that I set off for Europe, so that’s a good one too.

The week beginning the 15th November also sticks in my mind, as it was the week I started my phased return to work.

8. What was your biggest achievement of the year?:

Travelling around Europe for a couple of weeks on my own and getting back to work, albeit for only a few hours a week.

9. What was your biggest failure?:

I’m not sure it is a good thing that the first thing that comes to mind is my failed suicide attempt. Definitely a failure, but whether that is a good or a bad thing is up to debate depending on my mood.

10. Did you suffer illness or injury?:

Mental illness never really goes away. I also battled with side-effects and tummy troubles a lot. My jaw has continued to be a problem too – I have a visit to the Dental Hospital on Monday to see the Temporomandibular Joint specialist. I had a common cold over New Years at both the start of 2010 and 2011 too.

11. What was the best thing you bought?:

Either my InterRail pass or Glastonbury Tickets. My prescription pre-payment certificate should probably be considered too.

12. Whose behaviour merited celebration?:

Nikki dog’s behaviour merits celebration and reprehension on a daily basis!

13. Whose behaviour made you appalled and depressed?:

Occasionally The Bloke’s, but like Nikki, he can merit celebration too.

Dr M made me pretty appalled at the start of the year, but I don’t mind her so much these days. I may even confess to liking her!

14. Where did most of your money go?:

The usual – rent, food etc. The dog spends a lot of it too!

15. What did you get really, really, really excited about?:

I don’t tend to get really excited about anything when I’m feeling low. I was quite excited about the InterRail trip, although it was such a spur-of-the-moment thing that I didn’t have much time to get excited about it beforehand. I was quite excited about Glastonbury this year too – I actually felt able to enjoy it!

16. What songs will always remind you of 2010?:

Regina Spektor – Laughing With
Lady Gaga – Just Dance – especially reminds me of watching Dancing on Ice in hospital last January.
Laura Marling – Goodbye England (covered in snow)
The XX – Intro – reminds me of the General Election coverage on the BBC mainly, but also of the start of their set at Glasto.
Marina & The Diamonds – Obsessions – and pretty much the whole album really. She was great live too.
KT Tunstall – Weirdo – and again the whole album and seeing her live.
Miike Snow – Animal – reminds me of InterRailing. They played it a lot in the hostel in Krakow.
Ellie Goulding – Your Song – and again pretty much her whole album.

It has been a good year for music. I’ve certainly listened to a lot more this year.

17. Compared to this time last year, are you:

i) …happier or sadder?: I’m a million times happier than this time last year. I was on a psych ward having just failed to kill myself, so not exactly at my happiest! Compared to 6 months ago though I’d be sadder.
ii) thinner or fatter?: A lot thinner. I’ve lost over 3 stone since I came out of hospital last February.
iii) richer or poorer?: About the same I think.

18. What do you wish you’d done more of?:

Working, writing, knitting, swimming, seeing friends… Lots of things really.

19. What do you wish you’d done less of?:

Feeling sick, lying in bed with no motivation, seeing doctors and generally everything related to being ill. Arguing with the bloke comes a close second.

20. How will/did you spend Christmas?:

We spent it in Wolverhampton with the Bloke’s mum and sister. His aunt, uncle and cousin also came over for Christmas dinner. I saw my parents on 27th Dec and a load of friends came around for a big Christmas Dinner on 28th.

21. Has there ever been a question 21?!?

22. Did you fall in love in 2010?:

Nope. Not with anyone or anything new.

23. How many one night stands?:

Again none. A somewhat laughable question for me I think.

24. What were your favourite TV programmes?:

I’ve watched quite a lot of telly in the past year. I love Only Connect – a fiendishly hard quiz, although I have gotten more used to it over the years and it doesn’t seem quite as hard as it used to be.

I enjoyed Sky1’s Must be The Music – it’s a blatant rip off of all TV talent shows, only the people involved had raw talent, write their own stuff and there is no stupid false drama involved. Dizzee Rascal, Sharleen Spiteri and Jamie Cullum judged it and were really good too. The girl that won – Emma’s Imagination was amazing.

I enjoyed Single Father, Lip Service, Mad Men and various other things this year too.

25. Do you hate anyone now that you didn’t hate this time last year?:

No, not really. I don’t tend to “hate” anyone. I try to avoid people I don’t like.

26. What was the best book you read?:

I read a lot more in the summer than I had in the past few years, but it has tailed off again since autumn. I read 1984 for the first time (ridiculous I know) which was awesome. I enjoyed the Stieg Larsson books (me and everyone else, then!). A Woman in Berlin was interesting too – I picked it up in the airport at Krakow and it was weird to read it only a few days after being in Berlin.

27. What were your greatest musical discoveries?:

I have listened to a lot more music than in the last few years, but I’m not sure how many of those things were new discoveries as such. I’ve enjoyed a lot of female pop and singer/songwriters this year – Ellie Goulding, Marina & The Diamonds, Laura Marling, KT Tunstall, Little Boots, Regina Spektor – although the latter few are hardly new discoveries.

28. What did you want and get?:

I guess some improvement to my mental health is the obvious thing. Getting my drivers license back is pretty good too.

29. What did you want and not get?:

A magic wand? I try not to want too much so I don’t get disappointed.

30. What was your favourite film of this year?:

I saw quite a lot of good films this year. I probably enjoyed Scott Pilgrim most. The Girl who kicked the Hornets Nest was good although I didn’t think The Girl who Played with Fire lived up to my expectations set by the book or the first film. Kick Ass, Toy Story 3 and Winters Bone are also contenders.

31. What did you do on your birthday, and how old were you?:

I was 24 this year. I had only just come out of hospital. A few of my friends and two of my aunts who live locally all went out for a meal. It was really tasty.

32. What one thing would have made your year immeasurably more satisfying?:

Mental Stability? – I’m surprised that this was part of my answer in 2007, which was long before I was diagnosed with any mentalism. It seems strange to me that at the end of what was a great year, I was still wishing I’d been a bit more stable and spent less time feeling low. I guess I’d somewhat forgotten that I was hardly stable before things fell apart in 2008.

I do think that being more stable and less depressed would have helped, but at least 2010 was an improvement on 200

33. How would you describe your personal fashion concept in 2010?:

I am not sure I do fashion concepts. I tend to wear jeans and some form of longish top or dresses over leggings/bright coloured tights. Now I’m back at work a bit I’m definitely leaning towards the tailored dress look. My suits don’t fit properly any more – too big!

34. What kept you sane?:

I think what sanity I have can be mainly put it down to one thing – Reboxetine (plus Lamotrigine perhaps – I wonder what effect taking Reboxetine on its own would have).

35. Which celebrity/public figure did you fancy the most?:

This always seems like a bit of a silly question to me. I don’t tend to be attracted to celebrities because I tend to need to get to know someone before they become attractive.

I also have a pretty pathetic sex drive these days.

36. What political issue stirred you the most?:

I’ve tended to try and keep a distance from most political arguments of late, mainly because the amount of mindless Tory-bashing has wound me up quite a lot this year and a lot of my friends are raving lefties. I am neither a tory, nor a lefty, but I am getting fed up of the way that people seem to choose opposition for oppositions sake, rather than looking at what is right or wrong about a policy.

I do care a lot about welfare reform and the NHS, but I’m not opposed to changes in the system in the way that some people are. I think we have to face up to the fact that the current systems don’t work and something has to be done.

37. Who did you miss?:

I miss a lot of old friends. I have lost touch with quite a lot of people over the last few years and I’m not as close to others as I used to be. A lot of my uni friends have moved away since we graduated too, so although we still see them occasionally, it’s not the same any more.

38. Who were the ‘best’ new people you met?:

I’ve met some great new friends locally over the past year or so, but I probably couldn’t think of any one person.

39. Tell us a valuable life lesson you learned in 2010:

Things can get better and depression may not last forever, yet recovery is not a smooth process either.

40. Quote a song lyric that sums up your year:

I can’t think of one in particular, especially as my year has been up and down. I may come back to this. I’m sure something will come to mind as I’m listening to music sometime this week.

Actually.. I heard You Say Party – There is XXXX (within my heart) the other day and those lyrics fit my mood over the last month or so.

When the morning comes
And the darkness presses on all sides
When the morning comes
I’ll have to fight

I will have a think to see if I can come up with anything more accurate.

_________________

So there we go. Another year, another meme. 2010 hasn’t been all that bad, although it started terribly and went down hill again a little during the last few months. 2011 hasn’t started too badly aside from the terrible cold over New Years, so fingers crossed it will be a good year.

A proper post is on its way. I am trying to get it written. Lots happening at the moment though and I can’t keep up!