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Posts Tagged ‘Bipolar

More Evidence…

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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?

Stuck at the bottom…

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

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

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

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

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

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

Yo-yo…

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

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

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

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

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

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

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

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

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

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

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

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

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

Or perhaps it does…

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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