Busy, Busy, Busy…

For someone that doesn’t work I seem to be awfully busy at the moment.

And it seems I won’t be going back to work for a while.

My consultant had been pretty keen for me to contact my employer to try and look for a strategy that would see me getting back to work, or at least to get me back in contact with them a little more. It was suggested that perhaps I could help out with some corporate citizenship work or at least have a contact in the area I could meet up with to discuss work. All of my contact has been with the HR team who are based in London. As I am not allocated to a project I don’t have a manager at the moment, let alone one in the North West. I don’t even have a “Career Counsellor” right now as mine is on maternity leave. So I’ve had very little contact with work and I’ve only been into the office once in the last 18 months (to get my laptop upgraded). The place has become completely alien and the thought of trying to go back is pretty scary. I don’t think Dr M realistically thought I’d be ready to go back in the immediate future, but she wanted me to consider doing something to give me hope of going back.

So I contacted my HR rep to see what she thought. She needed to look into this and wanted me to go see Occupational Health before she made any decisions. She didn’t want to allocate a new Career Counsellor unless I was actually going back, so that wasn’t an option, but she did say she’d look at finding a Manchester contact for me. She wouldn’t agree to the idea of me going into the office or helping out unless there was an OH report which supported this. I suspect their liability insurance wouldn’t be too happy if I was on sick leave, went into the office and then I hurt myself or something.

So I was referred back to Occy Health. An appointment was arranged and I saw Dr R on the 18th. I’d seen him before, 18 months ago. He had been nice last time and had a lot of experience in psychiatry, so I was glad it was him again. He remembered me and I tried to update him on what had happened. I have a document saved on my computer which covers all the main events of my “Mental Health History”, so I took this with me to refer to. I think he was pretty shocked at what had happened since I’d last seen him. At the end of the appointment he said that when he saw me last he’d expected me to have a pretty rough time over the coming year or so, but he’d never expected it to be as bad as it was.

He mentioned a lot of the usual occupational health stuff. Things about how work is generally good for people and that I should be encouraged to go back as soon as possible. He quoted the statistic that 50% of people who are off work for more than 6 months never return (Scarily, 75% of people off for over a year and virtually none of those off for two years or more ever return) and he commented on how long I’d been off. He said he was concerned about my chances, but he was hopeful that at least I have youth on my side.

He seemed genuinely worried that I may be dismissed due to incapacity if I was off much longer. I am worried about this because my Permanent Health Insurance payments would cease if that happens. He said he’d hate to think I’d have a life of benefits ahead of me. Not exactly what someone needs when they are struggling to handle the thought of being alive. He warned that with such a long absence and dismissal for ill health, I would be nigh on unemployable, which is a pretty depressing thought. I should have a great career ahead of me and instead I am dealing with the possibility that is over. I hope not.

We discussed whether or not I could go back to work. I don’t really think I am ready. I’ve only been out of hospital for about a month. My medication is still being adjusted and I am struggling with side effects and anxiety. Things are so unpredictable that I just don’t know how I can plan to go back so soon. I was pretty surprised when Dr M brought up a return to work in the first place, but I understand that I do need to go back as soon as possible and was willing to at least see what could be done.

He agreed with me though. He wants me to be fairly stable for a couple of months before he considers approving a return. He seemed a little surprised that I had even been referred to him so soon after coming out of hospital. He was uncomfortable with pushing me back too soon because there is too much at stake.

If I went back to work for a little while and struggled, ending back on sick leave, then I would not only lose my ESA for 6 months, but I’d probably end up losing my job. They’d be more likely to dismiss me if I failed to complete a phased return. Of course there’s also the very real risk that it would tip me back over the edge and I’d try and kill myself. Not exactly something anyone would want to risk encouraging.

We also discussed the fact I am waiting for therapy and I’m likely to find that pretty hard going. It would not be good for me to go back and then to start therapy. There is good chance that it will make me worse, before it makes me better and we wouldn’t want that to risk my return to work. He’d rather that I knew at least what was happening with my therapy referral before I go back.

He did agree though that we should be doing something to normalise work and the office a bit more. I need to be in contact with HR and I need to go into the office occasionally before I try to go back. At the moment I feel like I don’t belong there and I hardly know anyone. It would be good if I could get used to going in before I try and do any work there. He agreed that helping out with the occasional task might also be helpful and a good way of keeping me in touch with work. The more we can do to convince my company that I do still want to work for them and that there is a good chance that I will again, the better.

So that’s the plan. Try and get more in touch with work, keep myself busy and doing enough work related tasks as possible and lots of hoping that I will get better and stay well long enough for us to consider a return. I will probably see him again in a few months, all being well.

I left fairly pleased with the outcome. Dr R seemed to understand my predicament and agreed that I wasn’t ready to return. I am a lot more worried about my future though. He was genuinely concerned that I will end up jobless and moneyless. At the moment financially we can cope with being on sick leave, but if I lost my PHI payment or ESA then we’d really struggle. I am comfortable with the fact I have a job to go back to with a company that has treated me well. I’m pretty scared that this might change. I don’t know how I’d find a new job and try and get back to work all at the same time.

The report arrived last week and was pretty much as I’d expected. My HR rep seemed fairly happy with the report, although perhaps a little disappointed that I am not ready to return. She called me today to find out if there was anything else she could do to support me. I have been given a contact in the Manchester office now and I’m meant to be talking to her tomorrow. It was suggested that I talk to her about things I can do in the Manchester office to give me something to do and to give me a taste of work. I need to build up my confidence and remind myself that I can actually do that job. I worry that I’ve lost my ability to work. I am not as sharp any more. I’m so slow and unproductive. I struggle to concentrate and think. I worry I will just not be up to the job.

We will see. If I am to get through all of this I need to go back. I loved that job and I want to go back. I just hope that I can. I am very scared that I won’t.

Discharged…

So I was discharged on Friday.

I think my reason for discharge was more down to the fact they don’t know how to help me, than me being any better. The current bed shortage probably had something to do with it too. They are struggling for beds and suddenly they are trying to send us all home.

My consultant suggested that staying any longer would not be good for me. The longer I stay on the ward, the harder it will be for me to leave. You get used to the routine, doing nothing all day. You really can’t help but become institutionalised, living in the safe bubble of the ward. The real world gets stranger and scarier by the day. I was getting more and more scared about leaving. It was an easier life in there and I could just about cope with existing. Being home has been a shock to the system and I realise now how much I’d settled into inpatient life.

It feels pretty risky to discharge me. I know I can’t stay in there forever, but I don’t feel particularly safe. I felt safer on the ward, although in reality I probably wasn’t. I wasn’t on escort during my last week and I could have gone out and done something, but of course it’s the evenings and nights I find most difficult and I was always kept safe then. My consultant didn’t seem to be taking the risk very seriously. She seems pretty convinced I don’t mean it when I say I still want to kill myself.

I nearly didn’t get to come home last week. It was agreed that we would meet with my new care co-ordinator on Thursday, so they could work on a care plan before I was discharged. Unfortunately she wasn’t in work for some reason and my consultant was reluctant to let me go without a CPA. By this point I’d accepted I was leaving on Friday and I didn’t want things to change at the last minute, so I managed to convince her to let me go anyway. We agreed that I would be placed under the crisis team until my care co-ordinator sees me this week. They’re not visiting me, but I’m on the list so if I call they can respond quicker. The likelihood of me making the call, even if things are bad, would be slim, but it was enough to satisfy my consultant.

Then on Friday they closed the ward due to an infection outbreak. Probably Norovirus, a stomach bug had broken out. Patients and staff we dropping like flies and the decision was made to close the ward. No one in, no one out. There were doubts over whether or not I’d be able to leave, but permission was sought and I was allowed to go. I felt fated to never leave.

I also had chest/upper abdomen pain, which was pretty bad on Friday morning. At first I just assumed indigestion, but when it still hadn’t gone away by the second day I was starting to worry. I knew I should bring it up with the ward doctor, but with the stomach bug running wild, I knew I wouldn’t be able to leave if I showed any sign of being ill. I decided to keep quiet, but as the pain got worse on Saturday I was starting to regret it. Managed to get through until today and saw Dr N. He said it could be related to the Reboxetine and has given me some meds that should help. We shall see.

At first, it was a nice novelty to be home though. Not getting woken up at 7am, by a noisy nurse shouting “Good Morning”. Food that isn’t lumpy and grey. A doggy to give cuddles. Internet access and my normal phone. Being able to go out without planning it. It all made a nice change. I even got breakfast in bed delivered to me for valentines day (aww).

Sadly though, the novelty is wearing off and reality setting in. I feel pretty awful at the moment. Nothing has changed. I’m grumpy and anxious. The smallest thing is making me snap. I went to Creative Remedies and instead of making me feel better, I felt worse. I just wish everything would go away.

Anyway I have to stop writing. I want to try and write about my time on the ward, but not sure I’ll get much chance. I wrote a lot in my diaries, so I hope I can use some of it for a few entries.

Hope everyone is okay. Let me know your news! xx

Bombshell…

On Wednesday night Dr M dropped a bombshell and then ran away whilst it detonated.

Contrary to what was said in ward round on Tuesday, “yes, it does sound like a mood disorder. We shall discuss your notes and call you in later to discuss medication”, they are now questioning my diagnosis, saying my picture doesn’t fit with their understanding of Bipolar Disorder. Now, considering this is based on a half hour conversation with me and a couple days of uncharacteristically fast (for me) mood swings, I am concerned.

They said they want me assessed by the clinical psychologist, which may take “many weeks” before they make any decisions. She isn’t sure where I should wait, here or at home, but is concerned about my safety (which to be honest she needs to be! Being in here doesn’t exactly do anything to convince you life is worth it, when you have already given up).

She said she doesn’t want to change my medication as it might influence the assessment. No mention of taking me off my current meds, which could be doing the same!

Then the meeting was over and I was left to handle the fallout alone.

I am a little shocked. They haven’t seen my Priory notes as the CMHT has lost them. I was under the care of The Priory for many months and I think they had enough time to assess me. Not make assumptions based on a short conversation and observations over a couple of days, which have obviously been influenced by an overdose and stress!

I am concerned that the change of tack seems to have come after J spoke to them. What on earth did she say, especially as she didn’t exactly know me or get the full picture as I didn’t trust her?

I can also sense what is coming. A borderline diagnosis is ahead on the tracks and coming at me fast (or slowly as it’s the NHS). I wouldn’t mind if this seemed to fit, but I am fairly familiar with the criteria and nature of the condition. It doesn’t ring true with my experience. I have no fears of abandonment – I am fiercely independent and quite happy to accept someone won’t be in my life any more, e.g. when therapy has ended. I may miss the person or thing, but not object to losing it and will not try to stop them. I do not have stormy and unreliable relationships – I have been with my partner 7 years. We argue like man and wife and our relationship is strained by this episode of illness, but I don’t love him one minute and hate him the next. My mood swings are not generally reactive and *usually* slower than those suggested for BPD. I don’t suddenly want to kill myself after bad news. Yes, I can express frustration or be upset, but not out to a level that is out of the norm or to extremes. I do not act impulsively without considering the consequences. My major suicide attempts have both been a result of a huge amount of thought and planning. In fact, aside from my mood swings I don’t think I am generally a person of extremes. I also have no past trauma, which is often involved with the condition. I could probably half meet maybe 3 or 4 criteria, but never the 5 needed by the DSM or the descriptions given in the ICD. I’m aware I am having to simplify things through lack of space or time – my thumbs will fall off if I write everything I want to, but I think you get the idea.

Also worth noting that borderline PD is one of Dr G’s specialisms and she never mentioned it to me. She tends to be pretty straight with people, so if she thought it was that then surely she would have been able to say so? She also wouldn’t have referred me to Dr P, him being the mood disorder specialist.

I can’t help but feel this is all part and parcel of the way this label can be misused. Don’t fit classic diagnosis, don’t respond to first line medication, female, suicidal and have mood swings. Oh BPD will do. Lets try and put the square peg in the round hole.

Maybe they aren’t thinking Borderline PD, but the mention of psychologists and lack of anything else even remotely close, suggests they are.

I am also frustrated at the lack of desire to do anything whilst waiting for the psychology/therapy assessment. Even if it was BPD, medication can be helpful with treatment and is often following the same kind of strategy as Bipolar II. She may in a couple months time go back to my current diagnosis, make the same changes and in the meantime I have wasted months of my life stuck on this ward. There never seems to be much desire to get you out, unless they suddenly need a bed then you can be out on your ear, recovered or not.

There are a lot of questions and no one has given any answers yet. I wrote a list of the key practical ones and handed it to my nurse to pass on yesterday, but no mention yet. I suspect I will be waiting until ward round next week.

After all this, my bloke went to see Dr N yesterday for his opinion. I thought this would help but it has made me more confused. Apparently Dr N is quite pleased I am being reassessed as he was never convinced by my diagnosis and he even suggested Dr G wasn’t. I had suspected this myself, but when I questioned Dr G on it, she said she agreed with Dr P. My bloke and Dr N apparently discussed borderline PD for a bit too. My bloke also expressed his concerns about rumination (he seems to think if I stop overthinking and forget about my illness I will be okay) and my blog came up. Apparently Dr N didn’t know I was still doing it! Surprised by this as everyone else, including the CMHT knew. I kinda feel left out of my own care again, so am wishing I had been there yesterday, although I know it is not practical.

Since then I have spent a lot of the last day or so pondering all this. I had a visit from Em in the afternoon which was lovely of her and a short break from everything.

My bloke came in the evening. It was his birthday but he wasn’t exactly full of birthday cheer. Em had got me a cake to give him, which we shared some of, but then we spent the rest of the time talking about all this. He has been doing a lot of research, trying to fix everything and find solutions (typical man).

He has been going over the rumination thing and my lack of positive thinking. I know I overthink. I even overthink good things. The problem is I always have and it feels like part of me. Questioning that feels like a direct attack. It may be an exacerbating factor, but it isn’t the only problem and I also don’t know how I could really change this. I can tell myself to stop and distract myself, but the running commentary just carries on and questions me further. I will almost overthink, overthinking. Distraction works to a point, but when I stop I just go into thinking overdrive instead and I can’t distract forever.

He has all these suggestions of how I can get better and things I need to do. Thinking and therapy techniques, supplements, the usuals of exercise etc. Many of these I do try to employ already and it is all well and good to suggest them, but at the end of the day I am: a) unwell and that can make it hard to do anything, especially when I’m in crisis and all logic goes out of the window, b) stuck in here so many of the suggestions are impractical and c) they may help to some degree but none of these things are going to fix things.

It still feels like he basically wants me to buck my ideas up. I was getting frustrated by this. I know he means well and is trying to help, but I wish he was perhaps more sensitive in his approach. He has gone from acting caring and supportively over the last couple days to criticising me again. I do wish things were all as simple as a bit of CBT, some positive thoughts, routine, eating and exercising well and some distraction. Sadly they are not.

Edit: Maybe this is unfair. The conversation was frustrating and I did feel attacked at times, but I am glad he is trying to help. Some of his suggestions were helpful. There are good bits within the bad. I do just find it hard to see them and I don’t know how much I can do right now.

Today looks pretty bleak and pointless. More waiting and the thought of another long weekend ahead is tiresome. I asked about having Nikki, coming to visit so we could have a walk around the grounds, utilities the nurse said I need to get it sanctioned by the doctor. Considering I am not on a section and would be escorted by my partner this seems unfair. I wish I could just walk out and although in theory I can, they are unlikely to let me. A section would probably beckon, if only an assessment one.

I am tempted to ask for some haloperidol! It is the only thing to ever sedate me and although it turns me into a zombie, I’d quite like to sleep away a few days in an antipsychotic-fueled daze right now. It is not practical in the real world, but in here it doesn’t matter. I don’t have any PRN written up as nothing really works.

Anyway this is pretty long and I’m scared it won’t post! I better go. Xx

Testing Email Blogging…

I have no idea if this will work from my mobile email address and not my intothesystem one, but it is worth a try. I am not going to blog much as I guess I should be using my time here to try and get better. At least that is what everyone keeps telling me, but then again I am bored and it helps me to order my thoughts and write. All I have done is write. About 80 sides in my A5 paperchase notebook in 3 days. I am going to run out of space in a few days at this rate. Already using vast quantities of ink!

I think I am a little hypomanic at the moment. My mood has got increasingly speedy over the past 24 hours. It was horribly mixed last night. Desperately suicidal and wanting to self harm, yet bouncy and hyper. This morning I am just hyper and giddy. The bad thoughts aren’t as strong and are being replaced by a constant need to talk and write. I’ve been trying to calm down to avoid the chemical cosh. Avoiding the urge to dance around and sing!

Apparently I will see the psychiatrist tomorrow. I was hoping it would be today. Spoke to one of my named nurses for a bit just now though so they should know what my mood is like. I just about talked her silly I think. I seem to have got lucky with my nurses. They seem to be the two nicest staff here but they are both new, young and not disillusioned yet.

I just want people to be straight with me and tell me what is going on though. There doesn’t seem to be much involvement with the patients. We just get ordered to dinner and to collect our meds and that is about it.

Actually just after moaning my named nurse came back with a WRAP form saying that I should get involved with my CPA as I am clearly capable and enjoy writing. I guess I’m not being treated as a complete imbecile then! I am trying to make it clear I want to be involved and not just bossed about.

I shall sign off now. Don’t want to write a missive and it not work, but if all goes to plan I may write a little bit now and then.

Thanks so much to everyone for their kind messages of support. Especially to those who have texted or tweeted. You are helping to keep me sane! I say sane of course when I’m in a loony bin, but you know what I mean. Take care Xx

So Back Here Again…

So I’m back as an inpatient. Not the outcome I’d hoped for. I won’t go into the details of how I ended up here now as I’m on my mobile and it’s nearly lunchtime but I wanted to let you know. I know some of you already do.

Take care everyone, going to try and tweet a bit as it’s quick and easier than blogging and there really is nothing else for me to do here except stare at the ceiling. Kinda hiding from the rest of the place at the moment.

Xx

Am I Being Fair…?

A question that is plaguing me and my relationship at the moment.

My partner has been objecting to what I’ve written about our arguments lately. I am not sure he appreciates me writing about our relationship in such a public, but one-sided way. Maybe it is unfair to expect him to sit back without the opportunity to say his piece, but I need somewhere to work all of this out. I need to know if I am making sense. I need someone to listen.

He is of course right that I am only showing my side of the story and I am not giving him the opportunity to defend himself. Maybe I could let him write his own post, give his own argument, but I’m not sure it would be suitable for publication! ;) It is true though that much of what I have written has presented the facts and I am not trying to criticise or upset him with these posts. He did indeed call my illness a “stupid teenage fantasy” and does indeed make little snide comments about my blogging, so he cannot argue with that.

He tells me though that I do not realise how much the things I write hurt him and that I shouldn’t portray him as some big evil monster. I don’t mean to do that. He isn’t. We really do have our problems at the moment, but I don’t think he acts with any malice. I don’t think he gets any pleasure out of annoying or hurting me. He just doesn’t know how to deal with everything that is going on. I’m pretty sure he genuinely tries to understand better, but I am just not sure that it works.

One thing he said was that his sulking is not in any way aimed at me. He said that when he read about me stopping my medication he was really angry and that when he went off to sulk he wasn’t trying to manipulate me, he was just taking time out so he didn’t do or say something he may regret. That seems fair enough. There are times I have to take myself away from a situation. The problem is though I am unsure. Even if he doesn’t mean it that way, it still puts me on the back foot and makes me feel guilty. Of course he says that is my problem and that I shouldn’t think everything is about trying to hurt me. I guess it is my own fault for feeling guilty, but perhaps he should find another way of staying in control and maybe he shouldn’t give me the cold shoulder when I try and find out what is wrong.

When I said that our long conversation (argument) on Saturday night didn’t get us anywhere he was upset as well. He felt it did help and that we were getting somewhere. He argued that I am always seeing the negative in things and that we’re never going to get anywhere if I continue with that attitude. Yes, we did say things that needed to be said, but I am unsure if we actually got any closer to finding a solution. I know that he was trying though.

We had another one of those conversations on Sunday night. He said he’d been making a concious effort all day on Sunday not to make the biting comments I find so frustrating, yet I can’t say I noticed an improvement. This confuses me. Are things really not as bad as I think they are, but because of the negative nature of depressed thinking I am feeling things more acutely? Am I just making things up to taunt myself with?

We seemed to spend a great deal of time discussing the merits of twitter. I do think things have escalated on the blogging-hatred front since I started using twitter more regularly. You may remember that I wrote a blog post about my feelings on twitter about a month ago. I myself was sceptical of its merits, but I have come around because I do genuinely think it is helpful and dare I say it? I enjoy it. I enjoy being in the middle of discussion between an interesting group of people. I like the fact that twitter is taking my blog to new audiences. I like the fact it is quick and I can log my thoughts without having to dwell or develop them.

One of his arguments was that 140 characters is far too little to say anything constructive. I thought that too at first, but I am amazed at what you can actually convey through a few short messages. Thoughts after all aren’t logically constructed into sentences and paragraphs when you have them, so sharing a few snippets can still get across the same message.

His other was that he doesn’t understand why I want to broadcast little snippets of info to a bunch of strangers. He doesn’t really understand why I want an audience on my blog. I know I didn’t really start writing this for an audience. I started as I hoped it would be therapeutic, but I have found it helpful, interesting and encouraging to know there are people out there that care. I have met people who I do genuinely count as friends and I have received a great deal of useful advice and support. I wouldn’t get all that from a paper journal hidden under my bed.

As for twitter and an audience. I only really intended it to be aimed at my blogging audience. Little extra snippets of information for those that already read. Little updates for when I don’t have the words for more. It has developed into a new outlet though and also a new source of readers to this blog.

We also talked about me and my illness. His main argument was that I do not try hard enough to get better. This is an argument I hate, because it implies such a lack of understanding about mental illness, that I thought I could have changed by now. It doesn’t matter how hard I try, it isn’t going to take this illness away. I may be able to ease some of the symptoms, but that will be as far as it goes. Yes, I know that lifestyle changes can be useful and I even know that eating better and exercise can help, but it is not a panacea. The eat better, exercise more, be a better person stuff just doesn’t wash.

He is worried that I am pinning all my hopes of recovery on finding a wonder drug and/or therapy and that I am not going to do anything myself to get better. I am hoping that one day I will find a cocktail of medication that helps. Most of the people I know that have had some recovery have been aided in that by medication. It is often pointed out at The Priory that you should take a three pronged approach to recovery: medication, therapy and lifestyle change. By pinning my hopes for recovery on therapy and medication I am not being lazy, just realistic. I would also hope that the fact I have hopes for therapy (when the NHS finally get their ass in gear) does suggest I want to do some of the work to get better myself. Therapy is far from an easy process and involves a great deal of hard work, work which I am going to have to do.

As an example of how I am being lazy and not trying hard enough, he says that I haven’t done anything to improve my sleep, except take a few pills. I have tried medication, but I’ve been through the sleep hygiene stuff too. Admittedly I’ve made less effort in recent months, but only because I have given up hope. I have spent years swinging between hypersomnia and insomnia, although in recent years I’ve been firmly in the insomnia camp. I have tried all sorts of things and nothing has succeeded in restoring “normal” sleep. What is normal is questionable anyway, because there are times when 4 hours is fine, other times when 4 hours is no where near enough and even times when 4 hours feels too much. Sometimes I can have 2 hours sleep and feel fine. Sometimes I can have 2 hours sleep and feel awful. Other times I can have 7 hours sleep and still feel exhausted. I guess it’s all linked to mood, but I guess it also means my sleep will never be great.

He suggests I need to follow more of the CBT and self-help stuff we went over at The Priory. Setting myself a routine and activity scheduling. I do need to get back into a routine, but it is understandable that things go haywire over Christmas. I know activity scheduling was something that was always encouraged at The Priory, but I never really found it helpful. I also worry that this is just another means for exerting control. He can try and make me follow a routine he approves of and if I don’t stick to it, then he can get angry and tell me I’m not trying hard enough.

His latest suggestion is that I only use the internet/blog in the evenings to try and contain the time I spend on here, but I fear this is merely so he will be around at the time I’m doing it. Of course him being around will mean I will spend even less time on here because the automatic guilt-trip will be triggered and secondly, he will be able to keep an eye on me whilst I do it. When I tried to go online this morning, forgetting this had been suggested, he got angry at me and told me I was only allowed online at night and that I should do as I’m told. I had never agreed to following his suggestion, yet he was determined to enforce it. I am not sure I’m comfortable with his assumption that I will do as I’m told

I can’t remember what else was discussed on Sunday. I don’t exactly enjoy the arguments and I have found my short term memory seems to be pretty selective. Some of the bits that provoke the strongest emotion and reaction stick, but the rest slips through my hands like sand.

I do remember that I gave up before the bloke was ready to stop. I couldn’t take any more of the argument and at 2am or whatever it was I was too tired to discuss anything properly. He was annoyed at this, but I couldn’t help it. I didn’t want to start the discussion then anyway. It would be a lot easier to talk about such things when I’m actually functioning properly.

The thing is now I am confused and conflicted. I wonder if I’m being fair. I wonder if this is all my fault and if I am overreacting. I wonder if I am just seeing the negatives all the time. But things have got to the stage now that I am always suspicious of his motives. Is he trying to make me feel bad so that he can control me? Is he trying to guilt trip me into compliance? Is he just saying all of this to get his own way?

I wonder if anything will ever change. I really don’t know what to do.

Alison suggested on my last post we had some time apart and it is something I have thought about a lot myself, but I do not know how feasible it is. I hope that him going back to work will help. At least it will give us a few hours space. His cold is now improving, but his attempt to get to work this morning proved futile due to the snow. Both routes out of the village towards Warrington were difficult – one impassable and one almost so and he didn’t want to get stuck on the way back, so he turned around and came home. Unless it dramatically warms up overnight there’s little sign of him getting there tomorrow either. We’ve had another couple of inches since he got home this morning.

Even if he does get to work soon, a few hours apart probably isn’t going to be enough to help. Would a temporary separation be useful? It might make us realise what things we miss about each other and it might give me some space to get better. Our relationship was once long distance and it is true that absence makes the heart grow fonder. I just don’t know if he’d be happy about it and I don’t even know if I could. Things are not good at the moment and I wonder how Dr N and the CMHT will react if I am on my own. I wonder how I would cope. I worry that I would end up in hospital, perhaps not because he would get me sectioned or maybe even not because I couldn’t cope, but pretty much because there is no where else for me to go. I can’t exactly go home – my support is up here and I’d go mad after a couple of days with my parents anyway and I don’t really have any friends I could stay with. I don’t have anywhere else to go.

As has been mentioned before, I don’t think I am well enough to make any big decisions on our relationship whilst I am still in the acute throes of this illness. I am pretty sure things would be a lot easier if I was well. My illness has skewed the power relationship and I think that has escalated the worries about control. I think he wants to control me, because he wants to keep me safe. I am in a weakened position naturally, because he is my carer and ultimately if he wanted me in hospital he could make it so. Before I was his equal and I had things of my own and they gave me freedom. I had my career and my work friends, both of which I have lost through illness. I find it hard because I don’t feel I have anything of my own any more and that only adds to the feeling that I have no freedom anymore.

Admittedly we argued before I was ill, but it is true that arguments are a fact of life in relationships and things have been so much worse lately. The problem is, I can’t really remember the good times. A combination of depression and the effects of ECT means they’ve pretty much gone. I can barely remember our engagement. It makes it very easy to think that our relationship is all bad and maybe it should be over, when really things are just a little difficult at the moment and there is a lot going for us. NYE was our 7 year anniversary. That’s a long time and we must have been doing something right to get this far.

You would be forgiven for reading this post and thinking that our relationship struggles are the only thing going through my mind at the moment, but they are not. These struggles are the thing which I feel most able to write about, but on top of all this there are other struggles going on. I want to write about them, yet I am scared about doing so. The depression is pretty intense, but the agitation is back again and the only respite I have is my appreciation of snow. I love snow and it has been a welcome distraction from the worst of my thoughts. Sadly I know that as the snow melts that respite will disappear and I will be left with the misery that fills the rest of my mind. I do not relish that thought.

Face the Music…

I think it’s time I admitted something. I started to write about this a couple of weeks ago, but I didn’t feel up to facing the music. I didn’t post about it at the time because I didn’t want my bloke to know, but now this is over I guess I can admit it.

I stopped taking my meds.

I know it was stupid, but I did it anyway. I don’t know why I stopped. It started when I missed a couple of doses by accident sometime in November. I really didn’t notice any difference and started to wonder what would happen if I stopped taking my medication. It is something that has crossed my mind plenty of times, but I’d never really done anything to test it. I know my partner often questions the point of the medication and I often doubt it too. After all, I managed without it during my teens, even when I was unwell.

Anyway. I started forgetting to take my meds or messing with the dose. One day I’d miss the night-time dose. The next I’d skip the morning one or I’d try doubling something or whatever. I wasn’t taking any of it regularly and I wasn’t taking what I should have been.

This continued until I saw Dr N about a month ago. We were discussing increasing the Propanolol and he asked me something about my medication and it just slipped out that I’d been skipping doses. I don’t quite know how I ended up telling him really. I had made a concious effort to keep this a secret, but somehow it just slipped out. He gave me a mini-lecture and seemed concerned, but it was okay. He seemed to understand why I was doing it. He asked me if I’d tell Dr D and although I was very reluctant to do this, I did at our appointment last month. Dr D had little of value to say on the matter and just told me repeatedly to take my medication. This made me less keen on the idea! I don’t exactly have much faith in the man.

After I saw Dr N I did make an effort to start taking my medication again. I had been taking the Propanolol properly, hoping that it would help the headaches and generally I’d been taking the others too, but then the next thing I realised I’d stopped the Lamotrigine and Melatonin completely. I don’t even know when it happened. I just realised I hadn’t been taking any when I noticed I hadn’t used any of my new lot of medication. When I realised I had stopped I didn’t want to start again. I was worried about side effects and decided it was easier just to stay off them and I just didn’t care enough to bother.

Useless Social Worker, J asked me if I’d started taking my meds properly again and I outright lied to her. I seem to be making a habit of lying to her now. I feel bad about it, but I just don’t trust her. She asks me how I am and I tell her I’m fine. It just seems easier.

Then I returned to see Dr N a fortnight or so ago and he of course asked me about the meds. I couldn’t lie to him as much as I wanted to. He could see right through me anyway so I just admitted it. Again he was good about it. Concerned, but understanding. He even went as far as to say he’d probably think the same if he was taking regular medication and didn’t see much benefit to them. Unprofessional perhaps, but he knows me pretty well and I think his attitude is that any intelligent person would question such things.

He did point out though that I was less well than I had been a couple of months before and that I was heading the right way towards admission. He joked that he knew if I needed to be admitted again, it would take the men in white coats to do it. He is right of course. Voluntary admission to Hollins Park is just not happening. I’d consider somewhere else, but I’m not going back there if I can help it. I’ve actually been bad enough to consider that hospital may be the best place for me right now, but I’m not going to rush there in a hurry.

He asked me if I was throwing the pills away or stockpiling and I had to admit I’d been stockpiling. He was concerned that I was planning an overdose, which I guess was a logical assumption. I hadn’t been really though, knowing that Lamotrigine even in those doses is unlikely to cause much damage. Not to say that I hadn’t considered doing it anyway just in case.

He tried to persuade me to take the medication again. We agreed that I would need to titrate the dose back up, but we should do it quickly, unlike the usual 25mg increases used for Lamotrigine. So he didn’t give me another script for the Lamotrigine and sent me on my way with one for the propanolol – which I had still been taking intermittently. I was told to come back when I had used up most of my stock or if I needed to before.

So I reluctantly restarted the meds. My thoughts were confused on the matter. I didn’t want to because I didn’t see the point. In another way I wanted to because maybe restarting the meds so quickly would go horribly wrong and kill me anyway (there is meant to be an increased risk of The Rash). I also wondered if I continued to get worse whilst back on the medication then maybe people will not blame any deterioration on that and I will prove my theory right that the medication is crap. I guess the rational part of me also hoped that things would actually improve again.

I saw Dr N again this week. I told him I’d restarted the medication and he seemed pretty relieved. He said he had been quite doubtful if I would, which is fair enough. I doubted if I would. I think he was pretty worried about what might happen if I didn’t though and I suspect he questioned whether or not he should have been getting the crisis team involved, with a view to calling the men in white coats. I found it hard to talk to him this week though. I didn’t know what to say and was a little vague. I should have been more honest about how things are, but I fear those white coats. I was at the branch surgery too and I always feel uneasy there. I think it’s because it brings back memories of the silly overdose back in September 2008.

He asked if restarting the Lamotrigine was making me sleepy, which was possibly his way of telling me that I didn’t seem with it. I wasn’t really with it, but I didn’t know what to say. I didn’t think it had been. If anything it had increased the insomnia, but then again I may be more tired in the day due to sleep deprivation. I had little to report in the way of side effects, but I’m not sure I’d even notice any if they were there.

So how have I been without the medication? Did my experiment teach me anything? Yes, I have to admit I’ve not been well this last month, but is it due to a lack of medication? I know that everyone is going to blame my deterioration on the lack of meds, but I really don’t think it’s that simple. I think the fact I stopped taking the pills is probably symptomatic of the deterioration. When I stopped, things were already messy. I was very suicidal. I wasn’t thinking clearly. I was having weird dissociative episodes and felt out of control. I was getting worse anyway and because of that I didn’t care what happened to me. Stopping the medication seemed like a logical step.

I think about why I did it and I don’t really have any answers. My thoughts were racing through all sorts of things at the time. I guess maybe I just wanted to accelerate the self-destruction. I think I almost hoped that I’d go truly mad and finally have the impetus to try and off myself again. I’ve been holding on by a thread for so long I just wanted to snap it. I seem to spend so much time depressed lately, that I wondered if it is the medication causing it. In some ways the monotonous, not-quite-so-bad depression is worse than the actual pits of despair. It’s so dull and draining. I was truly fed up of it. I had been a little better, but I still wasn’t well and the knowledge of that was demoralising. If the best I can hope for is moderate-severe depression then I’m screwed. Life really isn’t worth it. I am perpetually suicidal and even the improvement I saw a couple of months ago was not enough to change that. I wanted out and this seemed a way to do it. I knew there were risks involved with stopping the meds and I wanted to take them. I felt awful anyway, so what was the point in the medication?

Part of me also wanted to see if I could induce some hypomania by stopping my medication. I’ve wondered a lot recently about what would happen if I was unmedicated. Would my little ventures upwards continue to escalate without the medication pulling me down? I want to experience the highs as well as the lows. What is the point in living with this awful mood disorder if I only get the horrible side of it. The depression and agitated mixed states, but none of the “nice” highs. I just wanted a change and hoped that by stopping my medication I’d be able to create that.

All the while I did have a small piece of rational mind that questioned what I was doing. I could feel I was getting more out of control, but this rational side was not strong enough to stop the rest of my mind. I think it was also overpowered by a little part of me that hoped this would be enough to make people realise I was struggling. Maybe it would help me to get more support. Perhaps it was really a pathetic cry for help?

Another theory is it was actually a way of stopping me from killing myself. By doing this I was trying to change things. I was trying to prove my medication wasn’t right. I was also trying to see if I could make things better without the medication. I needed a change. I couldn’t carry on the way things were. I was getting impatient again and the way things were going I’d have tried to kill myself out of frustration pretty soon anyway, just as I did when I was in a similar place at the start of the year. I’m annoyed that I didn’t spot the loop repeating itself, but maybe I did and this was my way of changing the course.

I also worry about what people think of me for this. I knew it was such a cliché to stop taking my medication and I hated being that cliché. I worry that people will think I don’t want to get well and that my illness is all my fault and that I’m just not trying hard enough. I worry about having non-compliance all over my notes.

Sadly my foray into non-compliance hasn’t really worked out as I had hoped. The lack of meds didn’t trigger any really nasty side effects. I didn’t get fits, like the patient information leaflet warns. I certainly didn’t get any highs. I just continued the way I was already going, getting more and more suicidal and losing motivation and energy all the time. I didn’t manage to kill myself, possibly because I am too depressed and can’t be arsed. I continued to pretend everything was fine and hid this from almost everyone.

I wonder what would have happened though if I Dr N hadn’t got this out of me so soon. If I’d stayed off the meds longer maybe what I’d secretly hoped might happen would have. I wish I had the chance to find out. I still don’t want to take the medication. I still see very little point. I noticed that I slept better without the Lamotrigine and with it my sleep has got worse again. I’ve felt a bit physically dodgy since restarting, which is a pain, but nothing overly nasty. I didn’t seem to get any withdrawals coming off the meds either. I don’t feel any better now than I was when I didn’t take them, so maybe things would have been the same with or without. It maybe feels like someone is trying to put the brakes on my snowballing descent though. I feel a little more in control, but then again, brakes don’t work in ice and I am not sure they are working right now.

Maybe a little longer and things will stabilise. Medication can take a while to kick in. Dr N suggested we increase the Lamotrigine after Christmas if things aren’t any better. I wonder if it’s worth trying something new instead. Yes, maybe this test has proved the medication does help a tiny bit. Yes, it is by far the best medication I’ve been on so far, but I am not sure it’s enough. If all the medication can manage is to keep my head above water, then what is the point? If things continue as they were then this will probably only happen all over again. That or I’d try and kill myself in frustration. It’s very true that you are at more risk of killing yourself when you are getting better. I proved that back in February.

So.. I’ve got that off my chest now. I am worried if there will be any backlash. I hope not.

ESA Medical…

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.

Opted Out…

Last week I tried to opt out. I ended up in HDU. I recovered physically and was shipped to an NHS unit, but I’ve finally escaped to The Priory again now.

It has been a turbulant and strange week. I do not know how I feel. Numb mainly.

So I am in hospital again. I do not know if and when I will be next online.

I hope everyone else is in a better place than I have been of late.

October 7th: Into the hospital…

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 7^th 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.