Posts Tagged ‘anti-depressants’
8mg…
I saw Dr M this morning. I’d not seen her for ages. It was back in July, just before I went to Europe (I haven’t written about my trip, but anyone following my twitter feed will know that I spent 2 and a half weeks InterRailing during July/August), so a lot has happened since then. She suggested that it was a good sign I hadn’t needed to see her sooner, but I indicated that it wasn’t especially. It probably would have been if I hadn’t have wanted to see her about a month ago. I couldn’t get an appointment then. This was the first Monday we could both do.
She asked about my trip. She was impressed and relieved that I managed on my own whilst I was away. It feels so long ago now, I didn’t really know what to say, other than that I coped, enjoyed most of it, but found it really exhausting. I could have told her more, but didn’t see the point. There was limited time and plenty of other things to cover.
We talked about things with the bloke. Before I went away, things between us had been somewhat up in the air. When I last saw Dr M, there was a very real chance that we would split up. I haven’t written about this here before now, because I don’t think the bloke would be overly comfortable about me sharing this with the world.
The whole idea of the trip to Europe, was to give us some time apart to reassess things. I was going to just take a “boring” holiday somewhere, but options are limited for solo travellers and I’d always wanted to go InterRailing, so I decided to give it a go. It also seemed like a great chance to test myself to see if I could be more independent and to cope on my own.
I’d talked about all of this at my last appointment and Dr M was keen to know what has happened since then. Things between us have settled down and pretty much gone back to how they were before things became difficult. It’s almost as if nothing had happened. Neither me, nor Dr M could decide if this was a good thing or not. On the whole, it is probably good. Things were not good at all when I left and it is nice to know that he missed me a lot, but it has also been a little disappointing. When I got back, we talked a bit about what had happened and how we should try to improve things and appreciate each other more. Unfortunately, it doesn’t feel like anything has changed or improved.
We talked about my trip to Occy Health. I explained what he said about not starting a proper scheduled return yet, but how we tried to think about the ways we can solve some of the problems that are stopping me from getting back to work. I told her that he’d said I could try to visit the office and that I managed to go to a meeting last week for a couple of hours, which she was impressed by. It was a really big step, so that’s good. However, she seemed disappointed that there was nothing further planned yet. I suggested that I will probably try to go in again in the next week or so, but I hadn’t decided when yet. She wanted me to try to commit to a time and hoped that I could start to go in on a more regular basis, even if it is only once a week for a few weeks. She thinks that a routine and commitment to going to work on a specific day, would help me prepare for it better. I said that is actually what I’d hoped for, but that Dr Occy Health wasn’t sure and she seemed to accept this, but she thought it would probably be okay if I chose to do it, rather than having my work-place imposing it on me. She may be right and I was considering this myself. I will try and decide when would be best.
We did talk about my mood and how it has recently dropped quite a bit. I don’t think she was too concerned or especially surprised, although she was possibly a little disappointed. She asked about the usual stuff . Sleep, suicide, anxiety… She was not surprised to hear of my nightmares or generally rubbish sleep (occasionally too much or usually too little and never feeling rested). I had to admit that suicidal thoughts had returned, although they were a lot less frequent and different to how they were a year ago. She hadn’t actually realised that the thoughts had pretty much gone away over the summer, which was a surprise. I’m sure I’d told her last time that I wasn’t really suicidal any more and that I no longer felt that life was completely hopeless. Although I can feel pretty awful at the moment, I have got my hope back that I can be well again. A year ago, I could never imagine a life without feeling horrifically depressed, so it was no wonder I could see no future and wanted to end it. I do get frustrated at the fact that I have got worse again. I wonder if I will always be waiting for the next relapse and if so, is it worth it? I am able to cope with these thoughts at the moment, as I still have some hope of a recovery.
We talked about the risk that I may do something impulsive if I have a particularly bad day. I told her there was no immediate risk of me killing myself and that I have no intention to make any detailed long-term suicide plans like I have in the past, but that I couldn’t guarantee that I wouldn’t just do something on impulse. I don’t tend to be impulsive and have never made the decision that way in the past, but if an opportunity presented itself, there are times when I can be very tempted to take it. She recognised this and I guess she knows that there is always a greater risk of completed suicide when people are either recovering or deteriorating. When you are really, seriously depressed, it is far too much effort to kill yourself, but when you’re having a bad day after a series of not-so-bad days it can seem a lot worse and you are also more likely to have the energy and drive to do something about it.
I mentioned that I felt that the arrival of autumn did not seem to be helping and she agreed that there was probably a seasonal element. She had noticed back in the spring that things seemed to improve a lot faster for me when the weather picked up in April, so it is natural, I guess, that things would get worse again when the summer ended.
We talked about my medication and she agreed that it probably needs a tweak, if only to help me get through winter. Her first instinct was to add Quetiapine. Apparently, it was licensed the other day in the EU as an augmentation treatment for Major Depressive Disorder, although she admitted that most psychiatrists had been using that way for a while anyway. She asked if I’d been on it before and I confirmed that I had. I was taking it along with Venlafaxine, back in February 2009 when I overdosed on it. She asked what doses I’d been on and I said I couldn’t remember but I did get right up to 550mg. She said that for MDD they use a max dose of 300mg, but I had been on that sort of a dose for a while too, so I’m not sure it would help. I also mentioned that it never seemed to help with insomnia and that I had put on weight last time. She said she didn’t expect it to help the insomnia and she seemed genuinely surprised about the weight. Although it didn’t help me with insomnia, I know plenty of people who find it knocks them out, so that seems a little strange. There are also plenty of people that have found it made them put on weight too, so I am not alone. Both drowsiness and weight gain are listed in the common side effects, so you would have thought she was aware of that. Anyway, I said no to Quetiapine.
The other options were to do nothing, increase the Reboxetine, swap the Reboxetine or try to add something else. I wasn’t sure doing nothing was a good idea and we both agreed that stopping the Reboxetine was a really stupid idea, as it is the first AD that has ever helped me. Reboxetine has shown that Noradrenaline is probably the key to my wonky brain chemicals and there aren’t many others that help on that front, so we’re not sure what else to do. She didn’t have any bright ideas of anything else to try really. If not quetiapine, then she said we’d probably be looking at augmenting with Lithium or another anti-depressant, but she wasn’t sure what would be best. She said she would have a look for some ideas though before I next see her and she was welcome to any suggestions I may have – so if anyone has any ideas, let me know. I’ve been on most of the common combinations already and my only real thought is perhaps bupropion, but it’s not licensed as an AD here (although it is used an awful lot in the US), so I don’t know if she’d give it a go. I know a couple of people who have found it helpful though, so it may be worth a try.
In the end, we decided that increasing the Reboxetine was probably the best option for now, although I am worried about how I will be with the side-effects. It is worth a go though and if it is too much then we will have to try something else. I hope it helps, without making me feel too awful. She said she’d get a letter sent to Dr N. I have plenty left at the moment anyway, so will just increase the dose myself for now. It only comes in 4mg tablets anyway, so it makes little difference. So yes. I am now going to be taking 8mg of Reboxetine. I didn’t actually tell her that I’ve occasionally taken 8mg anyway, when I’ve not been able to cut one of the tablets in half to make the 6mg. One day doesn’t make much difference though, but 8mg over a week probably will. We will see anyway.
After that, I remembered that I had also been for the therapy assessment. I told her what had happened and that I will probably be waiting for someone to come back from maternity leave. She named the person she thought it would be. We shall see what happens anyway. She isn’t impressed that I’ve been waiting over a year and was shaking her head saying “it’s probably only going to get worse, only going to get worse…” as she looked at her diary to book our next appointment. It really isn’t good.
Anyway, time was up then and I had to go. I see her again in 6 weeks, so we shall see how we go with the Reboxetine.
more of the same…
My life seems to be an endless stream of pointless days, filled with nausea, headaches and boredom. I sit at my laptop, trying to stave off the nausea that threatens almost constantly, refreshing three pages continuously, waiting for information to appear.
As always, I’m trying to write, but struggling to get my thoughts down. I seem to be collecting draft posts with one or two lines in them.
I am fed up of waiting to feel better. Three and a half weeks of mind-control pills and nothing seems to have changed much. I have just added side effects to the constant up and down and endless negative thoughts.
Last night, I’d returned to my state as a crumpled-up ball of agitated energy, fidgeting constantly and unable to slow down my thoughts. I had to retire to the spare room, where I could drum my fingers to my hearts content and stare out the window at the stars and clouds, waiting for daylight. I got some sleep, but I don’t think there was much. I wanted so desperately to sleep so I could get some respite from the endless nausea.
Today, the agitation has settled down a bit, although I can still feel the tension and energy bubbling away in the background. My thoughts are still far from clear, but are not the constant barrage that they were in the night. I am tired of this continual cycle. I am tired of everything.
Side Effects…?
I feel pretty awful right now. I’ve lost what good was mixed in with my mood and am just left with the terrible concentration, frustration and gloominess.
Physically, I’m feeling pretty terrible too. I have a splitting headache, am hot and bothered and feel sick. Last night my gums bled after I brushed my teeth and I woke up this morning with shaking hands, although that seems to have calmed down now. I have no idea if I’m actually ill or if they are all just stupid side effects or if it’s a combination, but I’m fed up. I wonder if I’m just been paranoid and it’s some evil placebo effect or if the medication can really be making me feel like this. I don’t know what to think or do about it.
Has anyone else had similar experiences with Fluoxetine?
We’re visiting my family this weekend. They don’t know about any of this, which means it could be a difficult weekend if I’m struggling with side-effects and having to put up my happy-front. I’m not sure I can face it.
Meh. I think I’m just going to go back to bed. I have stuff to do today, but I just feel awful.
p.s. is it just me or is the blogosphere quiet at the moment? I hope everyone is okay. I find myself refreshing the blog surfer page and wishing there was more to read.
All over the place…
…is how I feel today.
Last night I got very little sleep. I was fidgety, so much so, my other half sent me to the spare room. I couldn’t sleep, so sat up and tried to read. I managed to settle into my book eventually and I read for a few hours, but when I stopped I still couldn’t settle down and sleep. It was getting light before I was even asleep, but I was awake again before my other half got up for work.
My mood is still mixed. Both up and bouncy, irritable and agitated, sad and low. I’m not sure how you can feel all those things at once, or at least within quick succession of each other, but it seems you can.
I seem to be experiencing a strange side effect of the medication, or at least that’s what I assume it is. Since yesterday, I’ve felt like there is a ball of cotton wool wedged at the back of my throat, making it sore and dry. There isn’t, my tonsils seem fine and I don’t have any other signs of a cold so I don’t think I’m imagining it. I looked at the fluoxetine leaflet and dry mouth and sore throat are both listed, so I’m going to blame it on that for now, unless it does turn into a cold or tonsillitis during the next few days. It’s frustrating though. Not particularly painful, just there and annoying. When you’re irritable anyway, you don’t need something niggling away. Swallowing isn’t exactly comfortable either.
Aside from that I’m struggling to do anything much, yet getting annoyed that I’m so bored. I don’t really know what to do with myself. I want to do things, but then I don’t because I can’t concentrate and get frustrated too easily. I find myself flitting from thing to thing but settling on nothing.
A classic example of this, seems to be the fact that I can’t seem to bring myself to write any more right now. I don’t know what to say and am bored of myself already. I’ll try again soon.
EDIT: There is actually more I want to write about! That’s another problem. My Short term memory and attention span is terrible at the moment. What I have to write about is too long and complex for me to work out right now. It involves HR, liability, suicide and other things, but it isn’t clear in my head. Maybe later.
Going Backwards…
So I’m back to where I was 7 weeks ago. I’ve just returned to my GP and have been signed off again. The appointment didn’t go as I’d hoped. The second I walked in the door, I was reminded of how frustrated she makes me. I had written a lot of stuff down, but failed to share it with her. I just couldn’t bring myself to show her and the paper remained screwed up in my handbag, unread. I go in there and feel flustered and rushed and unable to explain things. I lose all semblance of coherence and talk utter rubbish. She makes me feel patronised and pathetic.
I did manage to talk a little about my agitated mood. She suggested the agitation could be a side effect of the medication, but wanted to persevere with them, telling me they can take a month or so to settle down. I am unconvinced. I feel the same way that I did a couple of months back, long before I was medicated. I am not sure I convinced her how frustrated this makes me feel. I am not sure she realises the extent of this mood. I know I failed to mention the s-word again.
We talked about work and HR’s worries. I suggested part-time work and she seemed reluctant. She seems to have this theory that if you’re fit to work, then you work, if you’re not fit, you don’t. She doesn’t seem to like the idea of a phased return or working a bit. I tried to explain that I think it would help. Doing nothing drives me mad, but she just told me I wasn’t up to it. I’m not sure I’ll listen though – need to talk to HR and see what they say instead.
In the end, I was shuttled off with my prescription for the next month’s worth of pills, a sick note for the next 2 weeks and an instruction to see her again. I tried to book the next appointment, but she’s on holiday. I’m glad. I think the receptionist was taken aback by my keenness to see someone else instead! A new doctor has started at the practice so I will see him in 2 weeks time. I just hope I can be more honest with him than I can with her. I just hope I can get through the next 2 weeks to actually see him. I’m not 100% sure I can. I know I have to take things a bit at a time.
One thing I’d been worried about, was the fact I still haven’t been completely honest with my partner over the past few days, or even weeks. Although he knows I’ve been off and knows I’m still not better, I know that I’ve maintained the front I have always had. I know that I’ve hidden the worst from him and made out that everything was okay, even if it wasn’t. He doesn’t know that I have a secret stash of pills, there for if I need them, let alone how close I find myself getting to needing them.
After the doctors I talked to him briefly. I let him know I’d been signed off again and I think he was surprised. I tried to explain things weren’t as better as I’d made out, telling him I’ve been struggling to concentrate with work and feeling agitated again. He doesn’t think a lack of concentration is cause for concern, pointing out that everyone has trouble concentrating at work and he joked that he’d like to be signed off for it! I don’t think he understood what I meant, although I did say that things are like how they were before I was signed off and I think he might get it now. I’m not convinced though. At least I can try and shake off the guilt a little. I’ve tried.
I don’t know what my next steps are. For now, I’ve told my manager and I’m waiting on HR. What is next though, I really don’t know.
return to the system…
…a different system to the one that my blog title refers to, but a system nonetheless. Tomorrow, I go back to work.
It feels too soon. I know it is too soon, yet I’m not doing anything to stop it.
I am too scared to go back to my doctor and tell her I can’t cope. I am too scared to tell my new line manager I can’t face it. I’m too scared to tell HR I’m not ready. I am too scared to admit to my partner I am not better. Hell, I’m too scared to admit to myself.
I want to be ready. I want to go back. I want to see my friends. I want to get involved in new projects. I want to feel like I have something to live for. I want to have something to do. I want to feel capable. I want to succeed.
I want to know if I’m ready. I try and work out if I’m ready, but all I feel is that I am not.
My mood had picked up over the past week. My holiday was pleasant. I felt almost capable. We did things. I enjoyed the sunshine. My appetite has returned. I socialised and it was almost comfortable. I didn’t feel suicidal all of the time, although I can’t say the thoughts had gone completely. I had moments where I forgot I was depressed. I wondered if the pills were working or if it was the holiday that made me feel better or if I was just feeling better anyway. Generally, it wasn’t bad. Not as bad as I’d feared at least.
The problem is I’m not on holiday anymore. I’m home and it’s harder to forget things. Things are suspended when you are on holiday. You can be someone that you are not and it is easier to forget the things that haunt you, the things that bother you. I was able to forget how depressed I was, albeit temporarily, because I was with people who only knew the happy me and I could show them the happy me. I did my best to shake off my moods and did my best to keep going. I wasn’t wholly successful and it’s a tiring act to put on, but generally I did feel a bit better. By pretending to be better, I almost convinced myself I was.
I’m home now though and I know I’m not better. During the drive back, all I could feel was churning anxiety in my stomach and my mind ticking over the things I faced when I returned. I didn’t want to leave the safety of the holiday. I didn’t want to come home. I could feel post-holiday blues descending like a big cloak of gloom. I know everyone suffers from post-holiday blues at the best of times, but I couldn’t help fear that mine would be worse than most. I couldn’t help worrying that mine would be a return to the suicidal depths of my depression. The fact that they haven’t been…quite, should be comforting, but I still worry that those moods are only days away.. hours away even.
Yesterday was a day of doing stuff. Unpacking, buying food, sorting things out, mowing the lawn. It was a list of chores, which a couple of weeks ago would have been unthinkable, but I managed them. I felt okay. Not as good as last week, but not desperately low. I wonder if I am improving, if I am better. Maybe I will be able to cope with work after all? I feel a bit better. I know I am anxious about work, but my mood has been much worse, even when I was still at work and performing well. Maybe the drugs are kicking in at last and maybe if I go back it will help me to get better? I keep trying to convince myself it is a good idea. I want to go back to work. I want to go back to pretending I’m fine.
I am trying to work out if I’m ready. The anxiety coursing through my veins, suggests I am not. The fact that I almost have a panic attack when I think of my inbox, suggests I am not. The fact I still find it hard to make myself do things, suggests I am not. The fact a conversation with my new line manager has put suicide back on the brain, suggests I am not. The fact I can’t face a future, suggests I am not.
Tomorrow I go back to work. I can’t stop it now. I will give it a go, but I just wonder how long I can last.
shiny happy pills…
So I took shiny-happy-pill number 1 this morning. Obviously it is going to have absolutely no effect on me at all for a few days (or weeks?!) but I still feel a little weird having done it. I know everyone is right and I have absolutely nothing to lose – at least the rational part of me does. The rest of me doesn’t see the point in doing anything, but nevermind.
Today is a stressful day. Unfortunately, stressful days = suicidal days. I can’t face the enormous task list ahead of me. The expectation of me to just get on with things. The expectation that I will complete all these tasks, despite the fact that getting up feels like enough of a challenge. The expectation that I will stop using “this excuse”. I hate expectation.
Lying in the bath half an hour ago, I’d have done anything to just slip under the water and stay there. It feels like the only thing keeping me here today, is the fact we have a friend here and his presence makes all of my possible plans useless.
Tonight, we travel down south for a weekend in a field, followed by a trip across the sea on Sunday night, for a week in France. I won’t be around for a while. The prospect of the holiday fills me with dread. I was looking forward to it, but now the day is here I can’t face it. I don’t feel up to a week pretending I’m fine and everything is normal. I don’t feel up to a week of putting on a happy face, getting up every day and going places. I don’t feel up to today. The packing, the cleaning, the endless list of tasks I have to battle through. I just can’t face anything.
I have no choice though. I guess this lack of choice, makes the ultimate exercise of choice even more appealling.
I must stop now. Writing here today is almost self-harm. It means I have even less time to complete the tasks of the day and it means I will be under even more pressure. I can’t help myself though. I almost want to put myself under this pressure. I almost want to tip myself over the edge, because then I won’t have to care anymore. Then I’d be able to just give up. I wouldn’t have this little portion of my conscience eating away at me, hating myself for thinking like this, being like this. I hate it.
return to the GP… and a return to work…?
So I’ve been back to my doctor this morning.
She’s changed her tune and now wants me to go back to work. Last time I saw her she didn’t want me to go back if I hadn’t picked up. This time she wants me to, even though I told her things hadn’t picked up. I wonder if the fact I’ve hit the month mark is making her itchy. I also wonder now if she’s given up on the hope that a break would help.
We talked a little bit about it, but I didn’t know what to say to her. She makes me terrible uncomfortable, just “hmm-ing” at me and being patronising. I realised today how much I hate her. I am not sure I can go back to her even. There are some new GPs starting at the practice soon, so I might try and get transferred. I know there’s little point me going to a GP I can’t trust.
I couldn’t be honest with her. I wonder what her response would have been if I told her what was going on in here. I can’t tell her how I feel. I can’t be honest with people face-to-face, not in the way that I can when I write. I told her that things hadn’t picked up, but I couldn’t bring myself to say the s-word, so I think she just thinks I’m feeling a little low. I suspect she doesn’t realise how low. In fact I’m fairly sure she doesn’t. I am still suicidal. More so today than yesterday. More so yesterday than Tuesday. So will I be more so tomorrow than today? I don’t know. I’m not sure I can get much more suicidal without actually doing the deed. I’m still fighting the thoughts, but it’s becoming more and more tempting to just give in.
I didn’t tell her any of that though. I just ended up agreeing with her to look at a return to work. In as much as I want to do anything (which is not much at all), I do want to go back to work, but I am scared. I have planned holiday for the next week, so she’s signed me off until 30th July. She said a short week to start off with might be a good idea and that gives me long enough to adjust to the idea of a return. I have no idea if I’ll be ready by then. I don’t feel ready, yet I wonder if it’s time to just try ignoring the problem again. Tackling it doesn’t seem to be helping much anyway, but I know where ignoring it got me. One thing I do know though is that I can’t stay off work forever.
The question of meds came up too and I think she was surprised when I agreed to her at least writing me a prescription. I have given up the fight I think. I just decided to do whatever she told me, as I didn’t know what else to say to her. I did tell her I might not go collect it, but I think I probably will. I hate giving in. I can be so stubborn sometimes. I don’t want to, but I read so often that you have to “keep taking the meds” that I should probably listen. I’m just not sure I want to. I’m just not sure I want to do anything. It seems Fluoxetine 20mg is going to be the drug of choice for the next 6 months though. So we shall see.
I am unsure about everything. The only thing I do feel sure about is that I can’t carry on like this. It’s just when I feel like this, the mind inevitably turns to the easy option. *bangs head on desk*