Into the system…

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Posts Tagged ‘doctor

On my own…

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My care-coordinator, C came to see me on Thursday. We weren’t meant to be seeing each other until Monday when I had my appointment with my psychiatrist, Dr M, but C called me on Wednesday to tell me she wanted to go through the updates to my CPA and risk assessment beforehand. When she arrived she told me the real reason she had came was to tell me she is leaving. It was nice that she wanted to do this personally and made the effort to make the appointment to see me before she went, but I’m sad that she’s going. She’s been asked to work in a CAMHS role, which is what she trained in. I think this is really positive for her and she seems excited about it, so I’m happy for her. I’d just got used to having her around and she was so much nicer and more helpful than useless SW, J, who I had before, so it is a shame. It was quite nice to know she was there if I needed her as I had faith in her, but I think I’ll be okay anyway.

I was asked what I wanted to happen now. I had the option of being assigned someone new or having no one assigned and letting Dr M and my GP, Dr N manage things for a while. I decided to go for the latter. I’ve never found the CMHT overly helpful and I am not sure I really need a social worker at the moment, although it was nice to have C there, just in case. To be honest, I think not asking for another person is more about trying to avoid another useless SW like J was. She did more harm than good I think. I’m not quite sure about the prospect of being a little on my own, but I think it will be okay. I’ve been told I can ask for one at any point and someone will be assigned, so this seems to make sense. I think whilst I’m just waiting to see if things stabilise there isn’t that much to do or say. It just seems to be a case of waiting to see if the improvements hold out. I do wonder if it will be helpful to have someone involved when I am trying to return to work, but we shall see what happens.

Saturday was a bad day. I guess one had to come along again at some point, but it was worse than I’d expected. I woke up feeling a little dodgy in a physical sense, but after a silly argument with the bloke things went downhill. I was crying almost non-stop for hours and when I wasn’t crying I only felt capable of staring into space. I couldn’t think and felt completely exhausted. It got to the stage where I couldn’t really speak properly and when we went to Morrisons I was struggling to do much more than walk around like a zombie, whilst my bloke did the shopping. Something just wasn’t right. I felt depressed, but I didn’t even have the energy to be suicidal. I was just devoid of anything. In the end I couldn’t wait to get to bed so I could start a new day and hope it would be better.

I felt a little better by Sunday morning and by the evening I felt okay again, so hopefully that has passed and won’t happen again. I don’t know if something just snapped or if crying wore me out, but it wasn’t good. I just felt so awful and it was horrible to be back in that place. I’ve not experienced that sort of catatonic depression much as I have a tendency to irritability and agitation, but it is scary when it happens. I don’t know how anyone gets through days or weeks or months of that. I guess the fact is, you’re so down it is impossible to do anything but wait. You don’t have the energy to end it.

On Monday I saw Dr M again. It was a bit of a nothing appointment really. We discussed how the last 6 weeks have gone, but there wasn’t much to be said. Things are still much the same as when I last saw her. I am a lot, lot better, but not 100%. Still getting the odd bad day that catches me off guard, but most of the times things are in the realms of normal. We talked about possibly increasing the Reboxetine again, but she was inclined to leave things as they are for now. She wants the option to manoeuvre the dose up again in future if things dip over time or if  I struggle whenever my therapy referral ever comes around. If she puts it up now, she wouldn’t really be able to increase it much more without pushing the side effects up into unmanageable territory. She asked if I’d heard anything about therapy, which I still haven’t. It’s getting a bit ridiculous because it gets pushed back further and further, but it doesn’t surprise me at all.

We talked about the fact I was seeing occupational health today and what I felt about it. She asked me when I next wanted to see her, which I felt was positive. I was given the option of two weeks, two months, whenever or never again. This would never happen with the CMHT, although I’m not sure how serious she was about never again! I suspect she may have had something to say about it if I chose that option. We decided I’d call her when I have decided though, based upon what was said at occy health and whatnot. She was good to point out I can call her whenever if I need to see her between appointments. I’ve been pleasantly surprised at how things have changed between me and Dr M. I didn’t like her at first and I really got the feeling she didn’t like me, but now she’s seen improvements and got to know me a little better and not the me she met when I was in hospital, things have improved. We shall see how things go. I don’t know what happens when I am passed back to the CMHT or discharged by her, but at the moment I’m appreciating the stability and glad I’m not being passed from SHO to SHO.

So today was occupational health. I have been worried about this one because the nice consultant I’ve seen in the past has left the firm. I have to confess to googling the new guy (another Dr G, so not sure I’ll be using that moniker for him) and I found out he has worked for the Health & Safety Executive in the past and has a more safety-focussed history than the last doctor – I got the impression ladders and chemicals were more his thing than mental health, but I could see he was an experienced occy health consultant, so he was going to have come across psychiatric patients at some point in his career. He seemed nice enough. Quite softly spoken and very keen to point out that he is not on anyone’s side and that he has my best interests and health in mind, so I guess that’s good to know. I’ve found that to be true for all of the occupational doctors I’ve seen. Every time, they’ve been supportive and they are not just trying to get me back in work. A pleasant contrast to the DWP/Atos Origin lot I guess, who only seem to care about declaring you fit for work (although to be fair in my case they didn’t).

We discussed how things were compared to last time I saw Dr R. In general, things have improved a little and the improvements have been maintained so that is good. He asked me how I felt about work and occupational health. I confessed to being in two minds – half the time itching to get back and on bad days, worrying that I’d never be well enough. He said that was to be expected, which I guess is true. I was pretty surprised that early on in the appointment he made it pretty clear he didn’t think I’d be returning any time soon. He feels it will be a long time before I go back properly and that I need to show stability for a while before we consider it. I was hoping to go back in some capacity soonish, so I’m disappointed really. I guess I have to slow down and wait and see how things go. I am aware that I shouldn’t rush things, but at the same time it’s about balance, because if I wait too long I will begin to feel useless and get frustrated.

He also said that a return will be very slow when it comes and it could be a very long time before I’m back at work properly. At first it will be just dropping into the office a couple of times to say hello and then maybe working an hour or two a week, building that up to a few mornings or afternoons and then we’ll see. I suspect I will get impatient with that approach, but I know it is what we have to do. I know though that I have a tendancy to do more than I’m meant to, so it will be difficult I think.

Now that I’ve been told I definitely can’t work yet, I feel a bit stuck. I’m having to wait and be patient and I am getting itchy. I had thought that I’d be going back sometime this summer. I expected to be setting a date to start a phased return, but I’m apparently not even ready to do that yet. I have to wait a couple of months before I see him again. If things have improved/stabilised then we can “possibly” start to plan a return. He did suggest three or four months before I next saw him, but I felt that seemed too far away. I’m worried I’d miss my window of opportunity to have some “normal” life. He agreed on two months or so unless I go downhill again in that time. He said I deserve to have a bit of happiness first, which I guess is a nice thought, although it also makes me worry he feels I won’t stay well if I do ever go back to work. I also wonder if I can be really happy if I’m not working. I want things to be normal. I want a career. I want to stay well.

In a way it is good. I know that I don’t have the worry of going back to destabilise things whilst I’m still not 100%. Maybe the therapy assessment will come through in time. It might be good to follow Dr R’s recommendation that I wait to see how I get on with therapy before I return to work. I don’t hold out much hope on that one though.

I guess this time of year is the best to be off too. Summertime. I won’t have to worry about taking time off for holidays. I can make the most of the sunshine, when it happens. I felt awful for most of last summer and I didn’t appreciate it. I am appreciating the sunnier days now.

I guess I can also stop feeling guilty and worrying about being on ESA and in the support group. When I have a good day and I feel normal, I wonder why I’m not at work. I am in the support group, which means I am meant to be too ill or disabled to ever consider seeking or returning to work. Until recently I thought that was the right decision, but as things have improved and I have got keen to return, I wasn’t sure I fitted that criteria any more. I always hated the thought that I was too ill to consider working, even though I knew it was true, but I find it even harder now I am not so sure. Before, I did fear I’d never go back. I couldn’t see any sign of improvement, but I hated the fact that others didn’t have much hope of improvement either. Now I can see that improvement I want to work. I loved my job and I miss it more than ever now. To be told I’m still not well enough to consider working is sad and hard to admit. The upside is though I should stop worrying they will accuse me of benefit fraud. I am not allowed to work even if I want to, so I have to accept that. Without the blessing of Occupational Health I can’t go back.

I just can’t shake off the feeling I am being held back, but at the same time I need to stop myself trying to run before I can walk. I’ve been off work for two years and during that time I’ve been very ill. I know that. 6 months ago I was in hospital. A few months ago I was still threatening to kill myself. Things have improved a lot in a short period of time, but unfortunately that doesn’t mean they can’t change back in a short period of time either. I hope they won’t. I don’t think they will, but it seems I have to prove that these improvements are going to hold out and I can reach some form of stability, before I can consider myself well.

Hmm. We shall see. We shall see.

p.s. I did a quick edit on this post on 9th June. I ran out of time yesterday so the last couple of paragraphs had been somewhat rushed and I didn’t say everything I wanted to. I also didn’t tag things properly. There is still more I can say on this, especially as I spoke to HR today, but I will leave that for another post.

ESA Medical…

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I know I’m updating a lot all of a sudden, but I guess there are things I want to document this week. My talkative mood is probably helping too.

I made it to my medical this afternoon. I am so glad it is over.

I was all over the place during the interview. The doctor kept asking the same things over and over again and it was tiresome. My head was spinning, thoughts racing, agitation brewing. I kept forgetting what I had just said and found myself getting more and more worked up. I couldn’t keep still from the agitation. It didn’t help that she wasn’t following things, but I don’t know if that was me talking too fast or her being a bit slow. She kept mixing my doctors up (I know it’s complicated. I still have 2 psychiatrists!) which was getting really confusing.

She didn’t seem to ask me much about what I can and can’t do. She did ask if I got up, dressed etc (yes, with bullying from my bloke). She asked me if I went anywhere (yes, if someone takes me – I mentioned Creative Remedies). She asked me if I saw friends and socialised (sometimes). She asked about driving (no, not since October 2008).

We talked a little about my overdose in February and what happened afterwards. We talked about ECT. I told her when I’d been in hospital. We talked about my current care – The Priory and transfer to NHS, who does what. She asked me a million times if my doctors knew what I was telling her and who was most up to date with everything. I didn’t know why she was asking that so much. Maybe so she knows whether to trust any information she gets from them or so she could check up on what I was saying?

She kept asking me about suicidal thoughts. She wanted to know why I hadn’t tried again if I still experience the thoughts. She asked me literally 30 times if I had any active plans, maybe even more. She seemed quite concerned when I was honest about the extent of my thoughts, even though I have no real means or firm intention to act at the moment.

I was forced to talk about anger and violence. I couldn’t deny that it has been a problem of late, but I didn’t want to be seen as “dangerous”. I felt so uncomfortable talking about it.

We talked about mood. I found it hard to convey what it is really like. I told her about the current agitation and how this is a fairly new development. She suggested the agitation could have been caused by anxiety about the appointment. I didn’t think it was and denied it at the time, but since I’ve thought about it some more I think it may well have contributed. I really was all over the place whilst I was in there and anxiety must have been exacerbating the situation. I tried to describe the aching, dull, flat, numbing depression that has lingered on and off for ages. I tried to describe the mixed agitated depression that is often a problem. I don’t think I succeeded on any account.

I mentioned that my partner had given up his job to care for me and she asked me about this. Is he with me all the time? How often does he leave me on my own? Who does what in the house? Do I ever go out on my own? etc. etc.

When we went over my meds, she seemed surprised that I am taking melatonin and even asked if it’s a hospital-only prescription. Considering melatonin can be bought over the counter in the US, it does make you wonder why it is so reluctantly used over here. The CMHT seemed surprised too.

At one point towards the end, she left the office to go ask her colleague something and I couldn’t help but burst into tears. I’d been holding myself together up until then, but the stress of it all tipped me over the edge. I don’t know what it was as I barely ever cry these days. Girlie hormones probably aren’t helping at the moment, but even still it seemed ludicrous. Unfortunately she came back in whilst I was trying to pull myself together and then asked me a million questions about why I was crying. I was worried she would think I was putting it on for effect or something. I genuinely couldn’t help it, but was so embarrassed and paranoid about it.

Although she asked me a million questions I don’t know if she has got anywhere near enough information. Most of the stuff didn’t seem to be very relevant to whether or not I can work. Maybe she was just nosy? I guess that’s her job.

I cannot convey how erratic the whole appointment was. Questions were being fired in all directions and I was so mixed up I couldn’t answer her. My sentences were blurring into one. I was jabbering on and on and going off on tangents. I didn’t say half the things I should have. I was not clear at all. I’ve been going over things in my head since, trying to make sense of it all. Trying to work out her intentions and what she was thinking and asking. I know I should just forget about it and wait for the results, but my head is just looking for things to think about.

One thing I have noted is the clear effect of stress. I was anxious and stressed by the situation and I could not deal with it at all. I was turned into a whirlwind of agitated confusion. I’m just thinking about work and similar situations where I have to answer questions and think about what I’m saying. Conference calls for example. There is no way I can handle one at the moment. It’s okay doing that with a doctor that is trained to deal with it, but it is not okay to talk like a madwoman in front of your boss.

In some ways my inability to deal with the situation may stand in my favour. I suspect now I probably came across quite mad. After all, I need her to think I am too ill to work. The problem is, I think I may have come across *too* mad. I was incapable of answering her questions and I’m worried I may have messed up in some way. I’m worried I didn’t answer things clearly enough or that I missed things out. I am paranoid that she was trying to catch me out. I’m really worried she will think I was putting it on or making things up. I wasn’t, but I wasn’t “myself” either and that could be problematic.

Afterwards I was tired and didn’t really want to do anything. The session took it out of me and I needed processing time. Kinda like therapy actually. I guess it was similar in that I had to talk a lot about how I was feeling and what has happened.

Unfortunately I wasn’t really given that processing time as my bloke wanted me to do stuff. He forced me to clean my car, which took ages at it was filthy. As I’m not driving at the moment my lovely little car spends most of its time sat on the drive. It has been sat still so long that green slime was growing on all the window seals. Not good. It’s looking better now, but there are still bits that aren’t quite there.

My thoughts are still racing. I walked the dog this evening and I thought that would help calm me down but it hasn’t. I was distracted thinking about the medical, work, suicide, random pointless stuff, everything. I have music spinning around in my head on top of everything else. The “We buy any car” advert is driving me mad… we buy any car, we buy any car, any, any, any, any, we buy any car… Make it stop, please!!

I suspect I won’t be updating quite so much in the next few days. Nothing is happening. We are taking the dog to a breed show on Sunday, but that is all I can think of. I will see Dr N sometime at the end of next week. I have Creative Remedies too, but nothing unusual or exciting coming up.

A Little Bumpy…

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The side effects continue to show themselves. Last night, a bumpy rash started to appear on my arm and today it has got worse. The ward doctor gave me antihistamine to ease the itching and it has helped but it’s still there. I will have to mention it again tomorrow if it doesn’t go.

Aside from the rash, my back and head have both been achy and I’m quite dizzy. This could be Duloxetine withdrawals, Depakote side effects or just general malaise but I wish I felt better.

Oh well…

Written by intothesystem

Friday, 24th April 2009 at 10:18 pm

A label…

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Earlier today, I had my second opinion meeting and review with Dr P. I wasn’t given much notice. The ward doctor, Dr C, just said he will be over in a few minutes and fifteen minutes later I was sat in a room with him and Dr C answering questions. It was a bit like the nth degree. My memory is sketchy and I struggled a little, but I gave him an overview of my moods over the past few years. He was keen to find out if I’d had any ‘up’ periods and although I have, I don’t want to exaggerate any of them so didn’t really know what to say. I just tried to explain how I was at various points in time. He had a little bit of knowledge about my history before he started and seemed keen to get an overall picture of my mood cycles. He asked about my agitiation also. It was a different approach to Dr G, who was more keen to get an idea about how I felt and what I thought. They’re polar opposite doctors, but both good at what they do.

Anyway, Dr P eventually said that based on my lack of response to ECT and anti-depressants he believes I have bipolar II disorder and thinks that ADs are not going to be helpful. I hadn’t realised that my lack of response to ECT could be seen as a test for bipolar. If I had recurrent depressive disorder, I’d likely to have had some positive response to the ECT, but because I haven’t, it probably suggests that anti-depressants are not going to work for me. He talked about how some people with bipolar II do not respond to ADs or traditional treatments for depression such as ECT and that was why he was suggesting that diagnosis.

He wants to start me on an old school mood stabiliser, so is putting me on Depakote. I am a little scared as I’ve heard bad thinks about Depakote, but everyone responds differently to different drugs and anything has to be better than the current situation. He is keen to take me off anti-depressants altogether. I’m glad it’s not lithium anyway.

He asked me what I thought and said that he suspected it didn’t really come as much of a surprise. At the time, I said not. I told him I knew a reasonable amount about the condition as I had friends with it and I had in the past suspected that it fitted. Thinking about it since though, it has been a bit of a shock. I’ve been seeking a diagnosis for so long and not received one, so to finally have one is a bit of a shock. It’s an unpleasant surprise too because I know that it can be an awful condition to have and I’m not sure I really want it, even if it does fit. After all, the last year has not exactly been a barrel of fun.

Dr G doesn’t yet know the outcome of the meeting. She isn’t in work today, but she is coming in tomorrow to see another patient so Dr C has written her a letter telling her about the meeting. I may end up seeing her tomorrow to discuss. I’m a little scared about her response to all this as I’m not sure what to expect. I presume she was aware that this was a possibility, because she wouldn’t have got Dr P involved if it wasn’t. Everyone is aware that Dr P is a specialist in mood disorders, especially Bipolar, and if anyone is going to spot it, it will be him.

Generally, I am still absorbing the information. I have suspected I would eventually end up with this label for a while, but it feels weird to finally have it. Dr G has avoided it so far and I wonder why, yet she obviously had her suspicions or she wouldn’t have got Dr P involved. I just hope she agrees with what has been said and is comfortable with it.

I think this has given me a little bit of hope. Things are changing, which is something positive. Hopefully, the new medication regime will improve the situation. I know it isn’t going to change things overnight, but it might pick things up. There is also the fact that this diagnosis should ensure I get more support. The CMHT referral is going through and they are trying to arrange a CPN before I am discharged from The Priory. The bipolar II diagnosis will give that referral more strength and also mean that the NHS pays more attention when I need support.

Aside from that meeting, I also have my GP coming to see me later today. I am a little nervous as there are a lot of things I have to cover with him, but he is lovely and I need to get over that fear. We shall see anyway.

Slipping Back…

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I realise now that a month ago, I was better than I thought I was. I thought there was no progress and I wasn’t getting any better, but now I realise it wasn’t as bad as I had thought. I was still low and the agitation was a problem, but I was coping then. The improvement on previous months was subtle, but it was there. I just didn’t really know how to see it. When you are depressed it is hard to see the positive amongst all the dark fog.

Now though, I can see. I am worse now. The juxtaposition between now and then makes it clearer. The upheaval of Christmas and New Year has done nothing for my mood. The endless charade of being okay and happy during the festivities is wearing and I’m tired. I find the blackness working its way through my mind and mood. The negative thoughts are relentless. There is a whole army of ants crawling around in there. I don’t have any ant powder. I have been existing for the sake of it for months now and I don’t know why I am still holding on. I keep trying to, but it is getting harder again. I do it for everyone else, not for myself. It is all just wearing. I am still wearing the mask.

I saw my consultant today. That was wearing in itself. I told her this. I told her that I was doing better than I realised, but now I am doing worse. I told her that I can feel myself slipping back and not having the energy to fight. She just said that this will leave me stuck in depression. She didn’t tell me how to stop myself or give me a hand to pull me back up. She just said that dips happen and I just have to keep fighting. I felt like she hadn’t listened and I found that hard. She has done nothing and said nothing today and I don’t know why I bothered to try and tell her how I feel. I am to stick on the same meds and she will review before I go away on holiday. I felt annoyed by her and maybe even let down. I don’t really know.

I am frustrated with myself that I have slipped back. I wonder if it is my fault. My fault for not realising things were improving. My fault for not making the most of that little improvement. My fault for not having faith. My fault for being this way. I doubt myself all the time and I’m punitive. I will wear myself down and beat myself up. I worry over everything. I question everything.

I think Dr G made a mistake today in the way she said that I may be trapping myself in my depression. I don’t know if she meant well or not, but it has upset me and annoyed me. It has not done anything to help me, only make me question myself more. I do not know why I have slipped back. I did not intend to slip back. It has just happened and I need a help out of it, not a knock down back into it. I hope things improve. At the moment it feels as if she is not supporting me or helping me. It almost feels as if she has lost the respect she used to hold for me. It feels unbalanced now. I am scared of her and uncomfortable about seeing her.

I don’t know what is next. I am always looking for answers. I don’t have any and don’t know where I can find them. I want to know when I will get better. I want to know when things will pick up. I want to know that they will pick up. I am looking for questions too. It is hard to find answers when you don’t have the questions. I don’t know what I should be asking of myself. I don’t know what I should be asking of my doctors. I don’t know anything any more. I find it frustrating.

Dr G wants to review before my holiday this month. Then she said we need to think about the future and planning beyond that. I am scared of the future. I am not sure I want a future. I am just trying not to think about it at the moment.

Written by intothesystem

Tuesday, 6th January 2009 at 6:08 pm

October 7th: Into the hospital…

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When I saw Dr G, I had been told I would probably have to wait about a week for a bed to come available, so I was shocked on Tuesday 7th when I received a phone call from admissions at about 9.30am. They asked me if I could come in for 11am as a bed had become available. I told them that there was no way I could get ready for then, so we agreed on 2pm. I then realised I had a mad rush to get ready.

I had to go shopping. I had no clean clothes and I needed underwear, nightclothes and slippers. My partner came home from work and we made a mad dash to pack and get the things I needed. We got ready and drove to the hospital ready for my admission. I was shown into one of the consulting rooms and asked to wait for the doctor. When they came, my other half left me to it and I went through the admissions process. The doctor on duty was terrifying. I didn’t like him and so rushed through the questions as fast as I could, leaving out loads of information. I hadn’t realised that the questions would be forming the basis of my initial notes and that they didn’t have access to the history I’d already given Dr G or I’d have made more of an attempt to be open and honest. I really didn’t like him. After the questions I was shown to my room and then came a short physical examination, which proceeded to make me feel very uncomfortable. He poked and prodded me and then handed over to the nurse. I was left for a while and then the nurse came back and asked me a few more questions, got me to sign a few forms and explained that he would become my “named nurse”. I was then left to settle in. I didn’t know what to do with myself. Slowly I unpacked my things and found my way around the room.

I was on 1 in 30 observations, so a nurse popped their head around the door every thirty minutes. Most of them introduced themselves the first time, but there was no way I’d remember any names. I was far too anxious and uncomfortable. Later someone asked me if I wanted to go to dinner or to order something to my room. I decided I had to brave the restaurant sooner rather than later, so agreed to go and get something. I was on escort, so that meant a nurse had to walk me between the different buildings, including the short walk to the restaurant at meal times. This was a status that was to remain the whole time I was an inpatient. Usually people were only on escort for a couple of days whilst they settle in, but they were anxious that I would do something stupid and insisted on keeping a regular eye on me. It was weird though being followed by a shadow all of the time.

On my first night I was met by a very manic patient, A, who decided she would introduce me to everyone. This was terrifying, but I was glad of it. She dragged me into the lounge and announced me to the fellow patients. I stayed for a while and talked to people, but I was pretty nervous and really wanted to run and hide in my room.

The next day was awful. I spent most of it alone in my room feeling terrible, occasionally interrupted for blood tests, a therapy assessment and other admissions rituals. The nurses would pop their heads around the door regularly and every time I was asked if I was okay, I would say yes, no matter how bad I felt. I began to look for ways to self harm and this became a focus. I didn’t know what else to do.

Thursday brought my first ward round, but I can remember very little of what happened. I can’t even remember if it was multi-disciplinary or one-on-one. I think it was MD, but Thursday ward rounds were usually 1:1 so I can’t be sure. It did bring about a change in medication. The Citalopram was to be phased out and Venlafaxine was to be phased in.

I also got to start therapy, which was a relief. It gave me something to fill my days with and stopped me staring at the wall, thinking about ways to hurt myself. This coincided with a fairly dramatic lift in my mood. I went from being suicidally depressed to hypomanic in a matter of hours and by Thursday evening I was running around the ward with A, both of us as high as a kite. I was agitated and couldn’t keep still, my mind racing at a million miles an hour. I retired to my room when I realised I was probably driving everyone else mad and then proceeded to draw all over my legs and entertain myself by listening to The Ting Tings on repeat. I don’t know what time I got to sleep. It was late. Friday was a continuation of this mood, but things started to darken on Friday evening. The weekend was spent on the ward and my sister visited, bringing cakes and presents.

The rest of my admission is all a bit of a blur. It was a great big melting pot of therapy, medication, mood swings, anxiety, depression, suicidal thoughts, lots of self harm, which was getting increasingly out of hand, ward rounds, nurses, visitors, CBT, art, agitation, friendship, talking, TV and jigsaws.

September: Caffeine Crisis…

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September 16th: Caffeine Overdose

A week on from the bridge I was a mess. I had spent the week trying to stop myself from hurting myself and I knew that I couldn’t withhold it much longer. The day before, I’d bought a packet of caffeine tablets. I don’t know why. Overnight I had gone over and over the urge to overdose and by morning I couldn’t stand it any longer. I took all of the caffeine tablets, 32 in all. I was surprised at how easy it was. I just swilled them down with a can of Diet Coke. I didn’t care what it did to me. I just wanted to shut up the noise in my head. I guess I knew that it wouldn’t kill me, but I wanted to make myself ill. I wanted to hurt myself. I wonder now if I took the caffeine to stop myself taking the paracetamol or fluoxetine or whatever else I could find. I wonder if I did it to stop myself from going to the bridge. I don’t know if there was some form of self-preservation happening.

The caffeine made me incredibly agitated. Shortly after swallowing the pills I was shaking and couldn’t keep still so I decided to go for a walk, hoping it would use some of my excess energy. I walked towards the village not knowing where I was going or what I was doing. My head was spinning. I felt drunk, dizzy and full of energy. When I arrived at the village I thought about seeing Dr N, but when I got the surgery I was too scared to go in and ask to see him. Instead, I kept walking. I sat down on a bench and texted a friend, then walked back to the surgery, but Dr N had left for his rounds. I gave up and walked home. By the time I got home I was feeling awful. I had terrible stomach cramps, was shaking and my head was pounding. In the end I just lay down in bed and stayed there. When my partner came home I just told him I was feeling poorly.

The night was long and painful. I was awake all night, the nausea unbearable. I kept heaving, but nothing was coming up. My head was spinning and pounding. My heart was pounding. I thought I was dying.

September 17th: A&E

In the morning I was still feeling terrible. My partner was concerned; of course, he did not know that I had brought the pain upon myself. I rang the surgery and made an appointment with Dr N. I was agitated beyond belief, feeling terribly sick and barely able to talk as I walked into his office. I was shaking terribly. I didn’t know how to tell him. I was so ashamed and embarrassed. In the end I managed to spit it out and explained what had happened. He was concerned and didn’t know how to react. He checked my blood pressure and kept asking me if I was going to be safe if he sent me home. I didn’t know how to answer. He decided to send me to A&E, gave them a call and wrote me a referral letter to take with me. He wanted me to call my partner and get him to take me, but I was too scared. I opted for a taxi.

I arrived at the hospital and handed the receptionist the letter. They took it from me and handed it to one of the nurses and then it was handed back. The letter was now open and I could read it. I was shocked to see what it said. Dr N’s differential included not just depression, but “? Personality Disorder”, which one would assume referred to the possibility that I had Borderline PD. I was quite angry. I hadn’t expected that, as it had not been mentioned before, but I also kinda knew that by self-harming in this way I had opened myself up to it. I sat in the corner and banged my head against the wall in frustration. Eventually I was called through, but a mix up meant I was left to sit in the cubicle on my own waiting for a nurse. One nurse saw my letter and said “oh you’re that one” and then ignored me. Eventually a nurse came and asked me some questions. She then found another nurse to take me through to majors.

I was shocked by what happened next. I was led to a cubicle and she instructed me to change into the gown and to get onto the bed when I was ready. I remember her asking me why I did it, but I didn’t know how to respond. She noticed my engagement ring and told me “see, that’s something to live for”. I thought she was an idiot. She obviously has no idea what it’s like. She attached me to the monitor and took my blood pressure and temperature, then left me. I proceeded to spend the next couple of hours feeling terrible, trying to work out what they were going to do with me. I was terrified. Everyone that came over and saw my notes seemed to flinch and wander away. I sneaked a peak at them myself and saw “DSH” in big letters at the top. I wondered if that was the reason why I was ignored. Eventually a doctor came and took some blood from me and asked me further questions. I was scared of him and didn’t know how to answer. He smelled too. Eventually he finished his interrogation and left me again. More waiting and being ignored followed. After what felt like forever, a nice nurse came and explained what was going to happen. I was to be moved to the CDU ward within A&E, to wait for the blood test results and a psychiatrist.

Shortly after I had been moved, my partner arrived. I was shocked to see him, as I hadn’t told him where I was. I found out that he’d been worried that he hadn’t heard from me and at lunchtime he had began a search. In the end the doctor’s surgery had told him I’d gone to A&E. When he arrived he was angry at me for not telling him the truth. He told me I was silly and kept asking me questions about what I had done and why. I just wanted to be left alone. I didn’t know how to respond. He kept asking me questions, in between hugging me and telling me things would be okay. I didn’t know what to say. I was starting to feel a little better by mid-afternoon. The nurse in CDU was lovely and the only one to really treat me like a human being. I was brought food, but it was inedible.

Eventually, I was deemed medically fit and the psych team were able to assess me. This was horrible. I was uncomfortable with the MHP. She asked me plenty of questions, but didn’t seem to want to listen to my answers. My answers didn’t seem to be what she wanted to hear. She didn’t seem to understand why I was there and I got the impression she just thought I was silly and pathetic. She was confused as I didn’t seem to fit her boxes. I think she just wanted to send me home, but realised I wasn’t happy about that. In the end she called the on-duty psychiatrist and he came. He didn’t ask me any questions about what had happened and just asked me what I wanted to happen next. He gave me the choice of going home and pretending nothing had happened, going home and having the crisis team visit or being admitted. I was scared of hospital, so I chose the crisis team. I was discharged after some frantic form filling.

September 18th: Crisis Team

The crisis team were hopeless. They turned up late and then proceeded to perform some bizarre good-cop-bad-cop routine, whilst they tried to find out what had happened prior to me tipping up in A&E. They asked me various questions but I didn’t know what to say to them. I made light of everything as I didn’t know how else to approach the situation. In the end I was deemed sane enough not to warrant their attention. They wanted me to wait for the mental health team assessment that I had been on the waiting list for forever. They seemed frustrated that they couldn’t just stick me in a suitable box and in the end they just discharged me back to my GP.