Long overdue post…

I thought it was time to explain where I’ve been, but I am not planning on staying long. Just a quick hello and goodbye for now. I feel bad it’s taken me so long, but I wasn’t sure what to say and kept putting it off.

I guess I have just been busy in the real world. That and the fact I had therapy. It seems that having a one hour session a week to contain any mentalism and to whine and moan, meant that I didn’t feel the need to come here. I have just 2 sessions of therapy left now, so by the end of August that may change. Maybe I will come back sometime, but I don’t know. My therapist was never keen on me blogging whilst I was seeing her and although I wanted to continue, in part to rebel against her disapproval, it just didn’t happen. I seemingly ran out of things to say.

I’m not sure how useful therapy has been. We have hardly looked very deep or at anything especially long-term. The therapy itself was neither very long term nor intense, but that didn’t surprise me. It might have been what I supposedly needed, but the NHS was unlikely to ever provide it. I will have had a total of 20 sessions, spread over 8 and a bit months. It would have ended a lot sooner had my sessions not been on a Monday, meaning plenty of missed weeks for bank holidays, my holidays, her holidays, sickness, her training etc. She’s away again next week. I can’t wait for the sessions to end and to get my Mondays back.

So aside from therapy I’ve been busy in the real world. My mood was really quite crappy in Feb and it got to the point where I gave in and started Mirtazapine on top of my other meds in the hope it would lift my mood and help me sleep. I wasn’t keen on the idea, but it seemed to help with the mood at least. It knocked me out for all of 2 days before the insomnia returned. Coupled with the arrival of spring, my mood recovered sufficiently that I stayed in work throughout the mini-episode, albeit on just a few hours a week.

Since then my mood has continued to improve and I’m now relatively “well”. My hours at work have been increased steadily and I’m now working part time, roughly 22hrs a week on some vaguely proper work rather than mundane tasks. I’m still internally based, but the work I’ve been doing has been pretty interesting and I’ve even had colleagues to work with, although we were at different ends of the country most of the time. I did get to spend a couple of weeks in London with them though delivering some training, which was awesome and I’m down again for a few days this week. I’m back to more mundane stuff again over the next few weeks though, but generally my employer have been good at finding me things to do and helping me to get back. I genuinely love my employer and my current HR team. They have been pretty instrumental in keeping my mood afloat and life feels hopeful. Dr N (GP incase you’ve forgotten in the last 6 months) said to me the other week he’s amazed at how well things are going and I’m inclined to agree.

The only remaining issue really is my sleep. It is still poor at best. When I have been working away it has been worse than poor. There have been nights where the whole experience has been painful and fear-inducing and I just wish night never happened and that my body didn’t need sleep at all. I take forever to get to sleep, when I do get to sleep I am drifting in and out of consciousness and dream worlds. I have frequent nightmares and strange dreams. Sometimes I am unsure where reality meets my dreams and everything becomes very strange and scary. I wake up and fall asleep dreaming and wake up and fall asleep and dream and wake up etc on a roughly 10 minute cycle for a few hours and then I can’t get back to sleep again and then often it’s time to get up. Or I am just awake for hours and it is only 6am or something when I fall asleep and then I should be getting up and can’t drag myself out of bed. There seems to be little to no sign of improvement, even after reducing the reboxetine in June. I explained how desperate it was making me to Dr N and he gave me an emergency supply of Temazepam in the hope that if I had a back up plan it might help reduce my anxiety about sleep. I’ve taken it on one occasion and it didn’t seem to help, but I’m too scared to take it on a night when I need to be awake the next day incase for some strange reason it decides it might work for once and I can’t get up! Benzos have never been much help though, but at least they don’t seem to make the whole dream/hallucination thing worse like the Z drugs do. Sleepers just don’t work. No chance of me ever getting addicted.

I’m still sleeping badly and basically just putting off the time when I should try and go to sleep this evening by writing here. I’m in a hotel again, which makes it worse. At home I’m made to go to bed at the time when my bloke dictates he wants to go to bed and I am forced to stay there so I don’t want to wake him or the dog up too much.. If I wake up from a nightmare or anything he helps to bring me back to reality quicker and his presence calms me down. Usually his snores are a reminder that everything is fine and normal and the wardrobe isn’t full of strange men trying to chase me (or whatever else decides to infiltrate my dreams and reality that night). Here in a strange hotel room the boundaries between reality and nightmareworld are a lot more blurred because there is no one to calm me down and I can never quite remember where I am. Monday night was bad. Just wide awake all night. No sign of sleep and increasing frustration at the lack of sign of sleep, which never helps. Yesterday was better, but still not great. I had a lot of dream stuff going on and the every 10 minute waking thing, but at least I got some sleep. I’m meant to be trying to keep a sleep and dream diary for the next fortnight for the therapist, but the problem is I often wake up panicked and even screaming, having no idea what it was that was making me scared. I rarely remember much content. I’ve been trying to keep the notebook by the bed and jotting things down, but that wakes me up even more and just prolongs the wakeful periods between the dreamfilled ones. The problem is though none of that sleep is quality. It isn’t restful and doesn’t recharge the batteries. Eventually I have to get the sleep somehow. During the first weekend of the last 2 week stint in London (a month ago) I just crashed and slept a lot (at least by my standards! I was in bed a lot). The second week was not so bad. The first week at home was better and last week less so. This week has been worse again. I could do with crashing and catching up again, but that is unlikely to be an option any time soon with a wedding to attend on the weekend.

If I could just get the sleep issue fixed I really could be convinced that life is getting back to normal and all will be well and good. Life is getting there. This may be “recovery”, but this is definitely holding me back. It still makes the prospect of full-time work scary and possibly impossible. My shortened days at the moment make the sleep issue less of a problem – I start work late and that seems to help.

Anyway, I should stop writing. I was only meant to be here to say bye and sorry for not saying it sooner. I seem to have written a massive post. Maybe I haven’t lost the ability to blog after all. I don’t think that means I’ll be back though.

I haven’t read many blogs of late either. I am very much out of the loop in terms of the madosphere and haven’t even read any TWIM since it moved. In fact I went weeks without looking at a single blog post, but I’ve read the odd one since, just to check you’re all still there. There are a few of you I miss a lot. Some I am in touch with in the real world. Some whom I’m not. If I’ve stopped reading, it doesn’t mean I’m not thinking of you. I do appreciate everyone who has been reading and around for me when I needed it and everyone that ever commented here. I feel a bit guilty for not being around for you, now that I don’t need it so much. Sorry.

I shall sign off. I may be back one day. I may be back another day. I may never be back. I don’t know.

Take care xx

A little unstable…

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Tummy Troubles…

I am still struggling with the tummy troubles. I have been taking the higher dose (120mg TDS) of Alverine Citrate for a few weeks now and I do think it has helped a little, despite the fact I have also increased the Reboxetine to 8mg in that time. I was getting less cramps at least, although I was still having problems with diarrhoea or constipation all the time. My appetite had improved a little, which must suggest things have been a little better.

Unfortunately that slight improvement has been completely negated by the events of last night. A warning – this post definitely scores high on a rating of too much information!

I had been feeling fine and had enjoyed my dinner of roasted ham, mash, kale and carrots. As I was getting ready for bed and just settling down to watch Newsnight, I got a sudden shooting pain in my tummy and next thing I knew I’d had a somewhat messy accident. :S :( I was so shocked and upset, it took me a second to act and jump into the bathroom (which is within a metre of the bed), although by this point it was far too late anyway. The bloke was horrified and just shouted at me, called me disgusting and hid in the back bedroom, whilst I stripped the bed and took a shower. :( I was feeling pretty rough by this point and thought I might be sick as well, but managed to keep that end under control! The bloke eventually realised I wasn’t very well and that he was being unreasonable and he apologised and started to make the bed. I didn’t know what to do with myself. He wasn’t going to let me in the bed after that, so suggested I got the air-bed out! At least that is plastic and cleanable in case of further episodes. I didn’t expect to sleep much anyway, so decided to do this and settled down under the spare duvet on the lounge floor.

I was awake most of the night and felt pretty rough, but managed to survive without any further accidents. I’m still feeling pretty dodgy now, although by now I could just be hungry. I am too scared to eat anything though.

I don’t really know how to say this, but the poo didn’t look good at all. Very dark brown, sticky, runny and lumpy including some undigested carrots. Not nice at all. The fact it happened so suddenly suggests things aren’t very happy in there either. If I could have done anything about it, I would have. There was no warning at all, except for the shooting pain that came with the attack. It literally came out and exploded like the lid off a pop bottle that had been shaken up. bleugh. Sorry. You don’t need to know that.

The bloke wanted me to book an appointment with Dr N, so I am seeing him this afternoon. I am not sure what he can say or do. I have no idea how I am going to tell him without dying of shame. Part of the reason I am writing this, is to practice describing what happened! I am far too British and shy to talk about poo. Even with a doctor. It has been hard enough to tell him of my tummy troubles so far, but this is an extra level of embarrassment.

I wasn’t sure about writing about this here as it is so embarrassing, but it is the latest thing to happen in the whole tummy troubles saga and something so horrible seemed worthy of note. After all, this blog is an account of some of the more grim elements of mental health. Coping with the side effects of medication is a big part of dealing with mental illness, so I may as well be honest about it.

My bloke was very shocked and not very impressed. He wants me to stop taking the Reboxetine if that is what is causing this. He said he doesn’t like living with an 80 year old. I agree. I don’t enjoy feeling like one.

I had been struggling with the increase in dose aside from this. My sleep has deteriorated and I only find I can sleep properly when the dose wears off in the morning, when I should really be getting up and taking the next dose. It takes ages to get to sleep, I am waking up all the time and struggling to get back off to sleep and I am having nightmares and feeling restless. It is exhausting. I was getting palpitations at night too, immediately after the increase, although that seems to have settled down a little after a couple of weeks at the higher dose. I felt really low in the first week or so too, but that also seems to have improved over the last couple of days, so maybe it is starting to have a more positive effect now. That said, I feel crappy today after the night I’ve had!

I am too scared to stop the Reboxetine though. I don’t want to go back to how I was before. I don’t want to end up really depressed and suicidal again. The perpetual low mood and vague depression of late is draining enough, but that constant despairing depression is much, much worse. I don’t know what alternatives there are. Maybe I should just go med-free and sod all the drugs and their stupid side effects. I still wonder if my mood would have resolved itself a lot faster if I hadn’t have started taking bloody medication. Then again, it may have killed me first.

In good news. I got my driving license back!

I now have a 1 year license, so I need to stay sane over the next year or I will lose it again. Apparently, I will get a form 3 months before it expires to request a renewal. They will go through the medical enquiries again and decide if to reissue. No doubt it will take 5 months again to do that, so I will not be able to drive again for a wee while, but I guess we will see how it goes next time. If I get worse or am told by my doctors to stop driving for whatever reason, I have to let them know and presumably I will have to wait months for them to decide again, so I hope that doesn’t happen.

It is great to have my car back. I am looking forward to going places and having my independence again. I think it will make a big difference in helping my recovery. Being able to go where I want and not having to rely on public transport or lifts from the other half is going to be a massive help. I have a lot more choice about what I do with myself and will be tempted to go out more.

I had a drive on Saturday afternoon after I’d insured and taxed it and it didn’t feel too strange to be back at the wheel. The bloke went with me and we made it in one piece. My left arm has remembered where all the gears are and it felt pretty natural, so I am glad I hadn’t forgotten it all.

On Saturday night we went out in my car and got pulled over by the police! I wasn’t driving, the bloke was. It had flashed up on the policeman’s dash that the car was uninsured – obviously the database hadn’t been updated since I had only insured it that morning. I am glad I wasn’t driving or I’d have panicked. I would say I’d have shat myself, (I think I did on Saturday night!), but I’m not sure that’s appropriate now! *blush* At least we can say the police are on the ball! We were off to a beer festival and although my bloke was only going to have a pint as designated driver, we decided not to take the risk of being pulled over again later, so we left the car and got a taxi back. We went back to get it on Sunday morning and I took my first solo drive, driving my car back. I was okay, although I had forgotten which lanes I needed to be in a couple of times, so I made life harder for myself.

Anyway, I need to get ready for my doctors appointment. I haven’t got dressed yet and am just lying on the sofa with a blanket. Walking around makes me feel worse, so the temptation is to lie here all day. I have a meeting to go to this evening though, so will have to get up eventually.

Edit (3pm): Appointment with Dr N was very embarrassing and not too much help. I had been taking senna daily, plus the occasional dose of lactulose to counteract the constipation I was struggling with, but he thinks that won’t help on the maintaining control front, so I should stop that for now. If I don’t take it, I usually end up in pain and bloated from the constipation within a day. He has given me a script for something else to take if that happens, so we shall see how we go.

We talked about coming off the Reboxetine, but he didn’t think that was worth the risk at all. We don’t know if my mood picked up spontaneously or if the Reboxetine helped, but either way, my mood is a lot better and it doesn’t seem wise to mess around with it. I may have to drop the dose to 6mg if the problems persist, but I was struggling enough on that dose, so don’t suppose it makes much difference.

We talked about sleep and he asked if I wanted to try more sedatives, but neither of us really saw the point as they don’t seem to help all that much. He made the suggestion that actually getting back to work and having more brain stimulus may help, which in theory is true, but I never slept that great when I was at work. Even when I have been busy lately, it hasn’t made any difference, so I’m really not convinced by this. If anything if my brain is busy during the day, I really struggle to slow it down at night, especially if I get anxious too.

Mentioning work, I told him about seeing Dr Occy Health again on Thursday. He thinks I should push to agree a planned return to work as having a structure and plan may help give me something to aim for. I think he is right, although I am wary of the risk of too much, too fast. I told him about going in a couple of times and he agreed that was promising, although I also said that my work are very hesitant to let me rush back. They are being very cautious about how much I can do and when I can do it. I actually got told off for doing work-related activities whilst I was there the other day. We will see though.

8mg…

I saw Dr M this morning. I’d not seen her for ages. It was back in July, just before I went to Europe (I haven’t written about my trip, but anyone following my twitter feed will know that I spent 2 and a half weeks InterRailing during July/August), so a lot has happened since then. She suggested that it was a good sign I hadn’t needed to see her sooner, but I indicated that it wasn’t especially. It probably would have been if I hadn’t have wanted to see her about a month ago. I couldn’t get an appointment then. This was the first Monday we could both do.

She asked about my trip. She was impressed and relieved that I managed on my own whilst I was away. It feels so long ago now, I didn’t really know what to say, other than that I coped, enjoyed most of it, but found it really exhausting.  I could have told her more, but didn’t see the point. There was limited time and plenty of other things to cover.

We talked about things with the bloke. Before I went away, things between us had been somewhat up in the air. When I last saw Dr M, there was a very real chance that we would split up. I haven’t written about this here before now, because I don’t think the bloke would be overly comfortable about me sharing this with the world.

The whole idea of the trip to Europe, was to give us some time apart to reassess things. I was going to just take a “boring” holiday somewhere, but options are limited for solo travellers and I’d always wanted to go InterRailing, so I decided to give it a go. It also seemed like a great chance to test myself to see if I could be more independent and to cope on my own.

I’d talked about all of this at my last appointment and Dr M was keen to know what has happened since then. Things between us have settled down and pretty much gone back to how they were before things became difficult. It’s almost as if nothing had happened. Neither me, nor Dr M could decide if this was a good thing or not. On the whole, it is probably good. Things were not good at all when I left and it is nice to know that he missed me a lot, but it has also been a little disappointing. When I got back, we talked a bit about what had happened and how we should try to improve things and appreciate each other more. Unfortunately, it doesn’t feel like anything has changed or improved.

We talked about my trip to Occy Health. I explained what he said about not starting a proper scheduled return yet, but how we tried to think about the ways we can solve some of the problems that are stopping me from getting back to work. I told her that he’d said I could try to visit the office and that I managed to go to a meeting last week for a couple of hours, which she was impressed by. It was a really big step, so that’s good. However, she seemed disappointed that there was nothing further planned yet. I suggested that I will probably try to go in again in the next week or so, but I hadn’t decided when yet. She wanted me to try to commit to a time and hoped that I could start to go in on a more regular basis, even if it is only once a week for a few weeks. She thinks that a routine and commitment to going to work on a specific day, would help me prepare for it better. I said that is actually what I’d hoped for, but that Dr Occy Health wasn’t sure and she seemed to accept this, but she thought it would probably be okay if I chose to do it, rather than having my work-place imposing it on me. She may be right and I was considering this myself. I will try and decide when would be best.

We did talk about my mood and how it has recently dropped quite a bit. I don’t think she was too concerned or especially surprised, although she was possibly a little disappointed. She asked about the usual stuff . Sleep, suicide, anxiety… She was not surprised to hear of my nightmares or generally rubbish sleep (occasionally too much or usually too little and never feeling rested). I had to admit that suicidal thoughts had returned, although they were a lot less frequent and different to how they were a year ago. She hadn’t actually realised that the thoughts had pretty much gone away over the summer, which was a surprise. I’m sure I’d told her last time that I wasn’t really suicidal any more and that I no longer felt that life was completely hopeless. Although I can feel pretty awful at the moment, I have got my hope back that I can be well again. A year ago, I could never imagine a life without feeling horrifically depressed, so it was no wonder I could see no future and wanted to end it. I do get frustrated at the fact that I have got worse again. I wonder if I will always be waiting for the next relapse and if so, is it worth it? I am able to cope with these thoughts at the moment, as I still have some hope of a recovery.

We talked about the risk that I may do something impulsive if I have a particularly bad day. I told her there was no immediate risk of me killing myself and that I have no intention to make any detailed long-term suicide plans like I have in the past, but that I couldn’t guarantee that I wouldn’t just do something on impulse. I don’t tend to be impulsive and have never made the decision that way in the past, but if an opportunity presented itself, there are times when I can be very tempted to take it. She recognised this and I guess she knows that there is always a greater risk of completed suicide when people are either recovering or deteriorating. When you are really, seriously depressed, it is far too much effort to kill yourself, but when you’re having a bad day after a series of not-so-bad days it can seem a lot worse and you are also more likely to have the energy and drive to do something about it.

I mentioned that I felt that the arrival of autumn did not seem to be helping and she agreed that there was probably a seasonal element. She had noticed back in the spring that things seemed to improve a lot faster for me when the weather picked up in April, so it is natural, I guess, that things would get worse again when the summer ended.

We talked about my medication and she agreed that it probably needs a tweak, if only to help me get through winter. Her first instinct was to add Quetiapine. Apparently, it was licensed the other day in the EU as an augmentation treatment for Major Depressive Disorder, although she admitted that most psychiatrists had been using that way for a while anyway. She asked if I’d been on it before and I confirmed that I had. I was taking it along with Venlafaxine, back in February 2009 when I overdosed on it. She asked what doses I’d been on and I said I couldn’t remember but I did get right up to 550mg. She said that for MDD they use a max dose of 300mg, but I had been on that sort of a dose for a while too, so I’m not sure it would help. I also mentioned that it never seemed to help with insomnia and that I had put on weight last time. She said she didn’t expect it to help the insomnia and she seemed genuinely surprised about the weight. Although it didn’t help me with insomnia, I know plenty of people who find it knocks them out, so that seems a little strange. There are also plenty of people that have found it made them put on weight too, so I am not alone. Both drowsiness and weight gain are listed in the common side effects, so you would have thought she was aware of that. Anyway, I said no to Quetiapine.

The other options were to do nothing, increase the Reboxetine, swap the Reboxetine or try to add something else. I wasn’t sure doing nothing was a good idea and we both agreed that stopping the Reboxetine was a really stupid idea, as it is the first AD that has ever helped me. Reboxetine has shown that Noradrenaline is probably the key to my wonky brain chemicals and there aren’t many others that help on that front, so we’re not sure what else to do. She didn’t have any bright ideas of anything else to try really. If not quetiapine, then she said we’d probably be looking at augmenting with Lithium or another anti-depressant, but she wasn’t sure what would be best. She said she would have a look for some ideas though before I next see her and she was welcome to any suggestions I may have – so if anyone has any ideas, let me know. I’ve been on most of the common combinations already and my only real thought is perhaps bupropion, but it’s not licensed as an AD here (although it is used an awful lot in the US), so I don’t know if she’d give it a go. I know a couple of people who have found it helpful though, so it may be worth a try.

In the end, we decided that increasing the Reboxetine was probably the best option for now, although I am worried about how I will be with the side-effects. It is worth a go though and if it is too much then we will have to try something else. I hope it helps, without making me feel too awful. She said she’d get a letter sent to Dr N. I have plenty left at the moment anyway, so will just increase the dose myself for now. It only comes in 4mg tablets anyway, so it makes little difference. So yes. I am now going to be taking 8mg of Reboxetine. I didn’t actually tell her that I’ve occasionally taken 8mg anyway, when I’ve not been able to cut one of the tablets in half to make the 6mg. One day doesn’t make much difference though, but 8mg over a week probably will. We will see anyway.

After that, I remembered that I had also been for the therapy assessment. I told her what had happened and that I will probably be waiting for someone to come back from maternity leave. She named the person she thought it would be. We shall see what happens anyway. She isn’t impressed that I’ve been waiting over a year and was shaking her head saying “it’s probably only going to get worse, only going to get worse…” as she looked at her diary to book our next appointment. It really isn’t good.

Anyway, time was up then and I had to go. I see her again in 6 weeks, so we shall see how we go with the Reboxetine.

More of the same…

It’s been a while since I’ve blogged. I guess there isn’t all that much to say at the moment and I’ve been so busy with day to day stuff.

Generally my mood has been reasonable. I think I am “recovering”.

There are times when I pretty much feel “normal” now. I don’t really notice anything mood-wise, either bad or good, which I guess means things are fine. I am busy doing things and life goes on without too much fuss or strain.

I’m still getting dodgy days. Days when I realise things aren’t quite right or my mood is a little down. Days when I feel crap and want to hide in bed or when I am grumpy and irritable., but these days are generally manageable and usually roughly within the realms of “normal”.

I keep having to tell myself that even the non-mentally-ill have bad days and it is to be expected. I think I realise I’m still recovering and not completely better yet. My bloke seems to be having a fair few bad days himself at the moment! It feels a bit weird being the happier, less grumpy one out of the two of us.

I would say there has been one, maybe two days when things haven’t been good at all and I’ve worried that things are slipping or haven’t changed and that maybe I’ve been deluding myself. I am worried one of these days may push me to do something stupid, but I hope not and don’t think they will. I think I can cope with them, but it keeps reminding me that things aren’t quite “normal” yet.

I forgot to take my meds properly a couple of times over the weekend and I certainly noticed it, both mentally and physically. I could feel my mood drop and depressive thoughts creeping in, but realising I’d forgotten my meds put my mind at rest a little. I noticed the physical effects too – I felt a bit dodgy at the time, but since I’ve noticed the side effects from the Reboxetine are stronger again too – the overheating and sweating, the nausea. My appetite had been creeping back though, so maybe skipping my meds every now again will keep it down. Hmm, perhaps not such a good idea.

I was pretty surprised that missing a couple of pills had an effect so quickly though. When I stopped my Lamotrigine back in November I didn’t really notice anything, but I guess it is different with the Reboxetine. It has a short half-life and is meant to be relatively quick-acting, so I guess it makes more of a difference. I don’t like the idea though that just missing a couple of pills makes me feel so much worse and could be enough to push my mood back into relapse territory. I don’t like that my mental-health is in such a fine balance.

I saw Dr M yesterday. It was a fairly pointless appointment. Talked about what I’d been up to over the past 6 weeks, my improvement in mood, side effects, me and the bloke, life in general. Nothing very exciting really.

She wanted to do something to tackle the insomnia, but of course discussing medication we came up against the same thing we always do. I’ve tried pretty much tried all the main sleepers and none have helped. She suggested I try some Nytol, so I guess I should probably try that.

She had planned to increase the Reboxetine, but decided she would like to wait. She seemed to think that things had improved quicker than she’d expected and that maybe I won’t need a higher dose, but she said we’d see. Wants me to see how the next 6 weeks go and then she’ll decide. If my mood tapers off a bit or has plateaued too much then she will push it up again. I was kinda disappointed that she didn’t do this anyway. Although there has been a big improvement, there are enough of the dodgy days to give me concern and there have been more in the past fortnight than there were a month ago. We shall see.

I was going to write about life stuff too, but I’ve got a headache and I am tempted to rest. I shall give you a list of things in brief!

Over the past couple of weeks I have been busy…

• Doing lots of stuff for the Youth & Community Centre that I’m on the committee for: press releases, survey design and other bits and pieces. It’s very much like work and has been taking up a lot of my time. I am still pretty slow at getting things done and my confidence isn’t brilliant, so I end up checking everything a million times. I was getting pretty frustrated as it felt like no one was listening to me, but I’ve managed to get most things done now. It is probably good preparation for me trying to return to work though. Not sure what I will do when I go back though with regards to all my voluntary activities.
• BBQing. We had some friends over on Grand National day for a BBQ. We had a big dog over to visit. He’s a Scottish Deerhound and he’s lovely. Our doggy is besotted. There were also small children and lots of adults, so it was a little chaotic having two massive dogs running around too. Funny though.
• Visting Em. Went over to see her when she was in hospital a couple of weeks ago. It was lovely to see her, but she did look pretty poorly. :( Sad to hear that she is back in again too. I was going to visit her again, but as she’s got a nasty infection (MRSA :S), I’m not sure it’s such a good idea. Hopefully she recovers soon!
• Reading. After seeing The Girl With the Dragon Tattoo at the cinema, I’ve started on the books. Finished the first two of the millennium trilogy and started the third yesterday and already nearly half way through. I guess this shows my concentration has improved quite a lot as there is no way I’d have been able to get through 2 and a half 600+ page books a few months ago.
• Camping. We went to Lincolnshire for a few days and a friend, M came along too. Doggy loves camping. It’s a great big outdoor adventure and she gets plenty of walkies. We went to Sandringham to see the queen (not that she was in!), had a couple BBQs, went to the beach and watched Boston United play FC United of Manchester which was interesting. I felt too sick (after too much cider the night before) to go up Boston Stump, but M and my bloke did and from the pics, it looks like there’s a pretty impressive view.
• We went up to Northumberland over the weekend. Stayed in a hotel not far from Morpeth. The bloke grew up there, so we met up with some of his friends on Saturday night. We also went to the beach, wandered around Newcastle and went over to Cragside whilst we were there. I love the North East. Doggy was in kennels as we didn’t know what we’d be doing, but I felt quite bad as she would have loved it. She seems to quite like her kennels though.

Think that’s the bulk of it.

Anyway.. I have doggy biscuits to bake, a doggy to walk, dinner to cook and probably a million and one other things I could be doing… I really just want to curl up in bed with my book or to sleep. bah.

Reboxetine…

I’ve been taking Reboxetine for a couple of months now. I started on a stupidly low dose and even with that I started to struggle with side effects. It has been increased a couple of times now and the side effects are a nightmare… BUT I THINK IT IS WORKING!

Reboxetine is meant to be taken in divided doses; 4mg morning, 4 mg at night, but I haven’t even got that far yet because of the side effects. One of the biggest problems is insomnia. I started on 2mg in the morning which wasn’t so bad, but then they needed to add the night time dose and that pretty much stopped me sleeping at all. I couldn’t even tolerate taking 2mg at night without it keeping me awake. So they decided to move the full 4mg dose to the morning, which was a little better. I still wasn’t sleeping very well (around 4 hours a night), but it didn’t seem to make things much worse than normal.

The dose was increased though about 3 weeks ago and we now have a problem. I can’t really take a larger dose all at once because Reboxetine has a fairly short half life and wears off pretty quickly. It was suggested I took 4mg in the morning and 2mg at lunchtime. The problem with the lunchtime dose is I often forget. If I’m out and about I don’t normally remember to take it with me or even if I’m home I keep telling myself I’ll go take it and never do. If I end up taking it mid-afternoon or evening I have a nightmare trying to get to sleep. If I take it late at night I usually get to sleep initially, but wake up an hour or two later and spend the rest of the night awake. Even if I take it at the right time I still have a problem sleeping. The only time I seem to be able to sleep properly is around 7am-10am in the morning when the meds have worn off, when ideally I should be getting up. I am struggling with the lack of sleep and I’m pretty sure it isn’t helping ease my headaches.

Aside from the insomnia there is a plethora of other side effects to contend with:

Sweats are a big problem and at times I get so hot I seem to start shaking or I feel faint and dizzy. This happens even when it is really cold outside and I’m wearing short sleeves. I must look ridiculous going around in short sleeves when everyone else is wrapped up in coats and scarves. I end up carrying my coat around everywhere because I can’t bear to wear it, but that means I get wet!

The Reboxetine has killed my appetite too. At the moment it is not unusual for me to eat nothing all day, for my bloke to cook me dinner and for me to eat half of it and then give up. The only thing I seem to want to eat is sugar. Everything else makes me feel sick, especially chicken for some reason. I don’t know if that has something to do with the fact I spent a weekend throwing up a couple weeks ago and one of the things I’d eaten was a chicken slice, but it’s a little annoying. I’m fed up of the nausea. It does have an upside though. I have lost a bit of weight over the past couple of weeks, although I’m sure if I wasn’t just eating sweet things then I probably would have lost more. I may be eating less than normal, but I think I probably eat healthier than this usually.

I am still getting the occasional attack of upper abdomen/chest pain too. It was assumed this was down to acid reflux and it does seem to have eased off over the past couple of weeks, so maybe the omeprazole has helped on that front. I just hope it doesn’t get worse now that I’ve completed the course of meds.

Add the common medication annoyances of constipation and dry mouth to the list and you have a pretty comprehensive list of side effects. The stuff is making me feel pretty rubbish, on the physical side at least.

The side effects do seem to ease off a little when my body has had a chance to get used to the dose, but it is really not fun in the meantime. Dr M is pretty concerned about the side effects too. She has been reluctant to increase the dose each time I’ve seen her, although she knows she needs to. I’m not even on the recommended dose yet (4mg b.d.) and she thinks I will probably need a high dose eventually, so that means I’ve got a few more of these increases to tolerate. I hope that by persevering the worst will pass, but I know that every time the dose is increased again, all the nasty side effects will be back worse than ever. I don’t know if I can handle it getting any worse. I almost wonder if she should just stick the dose up to full strength and see what happens. I think I’d rather feel absolutely dreadful for a couple of weeks, rather than pretty rubbish for a couple of months. I just don’t know if I’d tolerate it or not.

Dr M even seems to be considering taking me off the Reboxetine because of the side effects, but I am loathe to give up on it yet. I can feel it improving my mood and that is a big thing for me. It is the only antidepressant to have done that without sending me completely doolally. I have tried so many different antidepressants and other medications that I had kinda given up on the idea that I’d ever find something to lift my mood. This has changed that. I now have some hope that medication may eventually help me.

I hate though that I find something that may actually help my mind and my sodding body won’t tolerate it. If I find something my body can tolerate, it does nothing for my mind. Why can’t I have both? There must be some meds out there that will work and not make me feel ill?

So, yes. The side effects may be doom and gloom, but I do think it is working. My concentration is improving and I feel able to do more. I don’t actually mind getting up in the morning now. I may be knackered from the lack of sleep, but at least when I wake up I am not filled with this absolute dread of facing another day. It may sound clichéd, but I feel a little lighter. I don’t feel like I am being crushed by this overwhelming sadness any more. Things are by no means fixed, but they are definitely better than they were.

The intrusive thoughts are less and have changed too. I sadly can’t report that the suicidal thoughts are completely gone, but they are different and less often. Before, I had reached a point where I was absolutely certain that death was the only sensible option. It was all that I could think about and it didn’t matter what I was doing or how busy I was, it would be in my mind and it was the ultimate goal. I wanted to die and I spent all day thinking about how I was going to do it as quickly and painlessly as possible.

I am not certain any more though. I still find life and the future pretty hard to comprehend, but I don’t see suicide as inevitable now. I am still struggling to resist the urge to just give up on everything, but I haven’t already given up. The thoughts are mainly impulsive ones now, rather than the pervasive ones that were there before. Generally, the thoughts are kept at bay when I am busy and they only really hit me when I am anxious or upset, or at night when I am struggling to sleep and have time to think. I am keeping myself busy to push the thoughts back, but I can’t do that forever.

When I do stop to think, I am scared. I am scared that it won’t take much to push me back down the slope. What if I have to stop taking the Reboxetine because of the side effects? Will I get worse again? What if I don’t keep getting better? Will I give up again in frustration? What if I just give in to the impulsive thoughts that linger? What if, what if, what if?

I am scared by the thought of recovery. I am frightened by the future. I have spent so long assuming there is no future, it is impossible to know what to do with one. I don’t know how to live my life if I actually get it back. Dr M and New Social Worker ask me what I want to happen in a month, 6 months, a year’s time and I have no idea. I have no real aspirations because I have given up on them all.

I wrote about wanting to go back to work, but I am not sure I can actually do it. It is too hard to comprehend. I have been off for so long I don’t know if I can remember what it is like to work. Illness, ECT and medication have all messed with my brain and I don’t even know if it functions enough for me to work anymore. I feel so stupid and slow these days.

I am worried that I am not strong enough to recover. I am scared of therapy. I worry that it will make me so much worse in the short term that I won’t be able to cope. I don’t even know what it is meant to achieve. If my mood is improving with the medication, maybe it is more down to chemicals than Dr M is willing to admit? I know there are other problems, but I don’t know how therapy is going to help. I don’t even know if or when it will ever happen. I’ve been waiting so long it is pretty hard to imagine ever coming to the top of the list!

I feel like a coward. It seems so much easier to just give into the suicidal thoughts even now. I know things are improving, but I am too scared of what lies ahead. I have got so used to the idea of suicide that it is almost comforting. It is strange. Suicide is a coping method, as much as a get out clause.

I know I just have to face it. I know I need to stop worrying and thinking about it, but I can’t help it. I guess everyone facing the idea of recovery has these thoughts. I have been trying to ignore them, but they have been niggling away at me.

I have to fight these thoughts. They fuel the negative and intrusive thoughts that linger. I am trying.

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.

Thoughts, Thoughts, Thoughts…

So I’ve not been sleeping well the last couple of days. A nasty cold combined with racing and distressing thoughts is tiring me out. I was wide awake last night for hours and hours and no matter how much I tried I didn’t seem to be able to switch off. Eventually my cold must have defeated me and I got a couple of hours of broken sleep, only to wake up to the sound of our dog whimpering and a continuation of the thoughts.

My mind had been fairly still and quiet over the past couple of weeks. My mood was that of low rumbling depression, hidden under a façade of festive cheer. My thoughts have been dark, but calm and slow. It made a change to the agitated depression that had been the main feature of 2009.

It seems though with this cold, my thoughts have quickened. I feel as if I’m in a quiet turmoil, with ever-racing thoughts bubbling under the surface. I start on one thing and it gives me a hundred leads to follow, all in turn leading to more. The thoughts circle and spiral out of control. I can’t get a hold on them.

I store my thoughts up for the night-time, trying to maintain a semblance of normality during the day. Being ill with this cold though has allowed me to stay in bed and I can drop the pretence of normality a little.

I need to untangle everything and write it all down so I can try and make sense of it all, but it would take me hours, days even. I could probably write 10,000 words and still barely scratch the surface. I suspect my bloke may be justified in his complaints if I tried to blog all of that. I’d like the chance to blog some of it though.

I feel so alone with these thoughts though. I don’t know who I would share all this with. I can’t work it all out, let alone express it to others. Some of these thoughts are thoughts I can’t bear to share. Some of these thoughts I desperately want to share, but I am unsure if it is wise. Some of these thoughts are too confusing to know what to do with. I alternate between wanting to share them and thinking it is a very bad idea. Instead they all go round and round in my head and I’m too scared to let them out.

I did actually try and share a few things with Dr N on Thursday, but that has only amplified my confusion. By sharing my thoughts, I have made them real and that has only made them stronger. This just makes it harder for me to tackle the rest.

I don’t really know what to do.

This argument is still rumbling on and I don’t feel strong enough to resist right now. I need time to write, but I feel too guilty for it. The pressure is on for me to get off my laptop and “go and do something useful”, yet I can’t summon the energy for that either. I wish I could hibernate and wait for this to blow over.

Stream of Conciousness…

I started this post on Monday, but didn’t get time to finish it. It’s now Sunday! I don’t know where my weeks are going. I keep snatching five, ten minutes or so to write, but it takes me half that time to work out where I was before. I keep wishing I could write more, but other things get in the way. I guess more accurately I could say another person gets in the way. My bloke is still not too keen on me spending time on here and that means I usually have to fit it in when he’s not around.

At Creative Remedies on Monday we were asked to write. To write and to keep writing whatever came into our heads for three minutes. I wrote something private, something which I had thought about writing on here for a while. My thoughts were about how I come across at Creative Remedies. I behave like I used to at work and at uni. Friendly, helpful, bright, but hiding how I actually feel. There is a front there that hides the illness. An act. I feel like I have two halves. One outgoing and intelligent, the other ill and flawed. One bright, one dark.

I soon wished I hadn’t have written this. The next step of the exercise was to place our work in a pile on the table. Each one would be passed onto someone else who would then highlight the bits they most liked. The idea was to give us suggestions of how we could turn our stream of conciousness into something a little more creative. I didn’t want to share these inner thoughts. I didn’t want to let anyone in and break down the front. It was made even worse because my notebook is distinctive so whoever got it would know it was mine.

I felt almost sick as I handed over my book. I was given someone else’s piece. Theirs was fairly personal too, but completely anonymous and it gave me no real idea of the context. It didn’t let me in like mine would let someone else in. I was jealous of the guarded nature of their writing.

I could see who had mine. They were writing fervently on my piece. I worried about what they thought. They hesitated to pass it back still writing away. She glanced over at me and mouthed the words “is this yours?”. I had to reluctantly nod as she brought it over to me. Everyone else was scrabbling away at the pile trying to find their own.

I looked at her words. They were kind and expressive, but I still felt a little violated. She had liked my writing, yet I still felt uneasy. She was worried for me. She could feel the sadness and emotion in my words and wanted to comfort me. She later asked me if I was okay. It felt strange and I wasn’t comfortable with her concern. I don’t know that I deserve it.

I know she will never see me in the same light. She is the one person that knows the façade isn’t real. She will look at me with suspicion wondering what is behind the act. Wondering how I really am. I feel like I’ve been found out.

It’s weird how I can write here, knowing anyone could read this, yet I am so uncomfortable. It’s weird how I’m actually considering dropping my anonymity on this blog, yet I didn’t want to drop the act with one person. How would I feel if the same person came along and read all of this? I don’t know.

I don’t know how I really feel about these two sides. I guess in some ways the act shows I am making progress. I can hold myself together in front of people now. I can portray a sense of capability and confidence.  I can actually do things and at times I even enjoy them. There have been times in the past year or so when there was no way I could hide anything and enjoyment was a foreign concept. I was a mess, unwell and visibly so. That’s not true any more.

Yet, I am not sure it’s a good thing. I wasn’t well a year ago when I was first admitted to The Priory and I behaved the same in therapy. I was the sensible, level headed, friendly one. I spent more time giving others advice than I did talking about myself. I was the helpful, confident person. People even wondered why I was there. I seemed fine. I wasn’t.

I don’t really like the act. I don’t like its return. I have worked so hard in therapy to break it down. To be more open and honest about how I feel. To be more true to myself. For the therapists at The Priory, I was making progress when I started to talk about myself. I was chastised when I went into helpful, clever mode. I wonder if I should chastise myself when I act like this now.

At times I wonder if the act was what broke me in the first place. The act was a problem before, back when I was at work. I kept going, working harder and harder to hide how I felt. At times fuelled by unidentified hypomania, at other times fuelled by denied depression. I didn’t want to admit I couldn’t cope. I didn’t want to fail. I wanted to be confident and capable and not at mercy of emotions or illness. I drove myself into the ground until I snapped and my world fell apart.

I am worried I will do that again. I have been doing new things and taking on new projects over the past few weeks. I have ideas, I want to do things, I want to be successful. It’s a familiar feeling. My life has been full of periods where I take on new things and projects, but more often than not I take on too much and cannot cope. With hindsight some of these periods can be clearly attributed to hypomania, but others I am less sure. I wonder if it is just my personality. I don’t want to immediately see everything as something to be pathologised, yet I also want to learn from the past. I need to recognise the patterns and change them. I don’t want to keep crashing head first.

I don’t know what my mood is doing at the moment. People ask me how I am and I don’t know how to answer. I’m depressed, yet am I? Yes, the signs of depression are there. I feel numb, empty, suicidal. Negative thoughts, anxiety, paranoia too. The physical signs are out as well. Headaches, insomnia, tiredness. It all points to depression, but it’s not the whole picture. I am excited about new projects, interested in things (albeit not everything), doing stuff. Where is the anhedonia? I don’t think it’s a mixed state either though. Not in a classic way. I am not really sleeping, but I am tired with it. My thoughts race, but no more than is really usual for me. I am a little on the snappy, agitated, quick-to-anger side, but not physically agitated or excessively so. I don’t feel like things are going too fast. yet. I wish my mind would make it’s mind up. I feel almost lost within my mood.

Going back to the topic of anonymity and this blog. I don’t really want to be anonymous any more. I am not ashamed of my illness and I think it’s so important people are open and honest about these things. We can’t break down stigma if we’re too afraid to talk openly about mental health.

I am not even worried about employers googling me. I have no intention to leave my company any time soon. Even if I was looking for a new job, if a company didn’t want to employ me after reading this then I wouldn’t want to work for them anyway. This may limit my career in future, but it’s something I’m willing to take the risk on.

There is a problem though and it’s my family. I am not sure I am willing for them to know how I really feel. I don’t want them to worry. I know my partner reads this already, but with my parents I am even more economical with the truth. I have never been open with them and I’m not sure I’m ready to start. I guess it is doubtful they will ever google me and find this anyway, but it is still a risk.

I realised though recently it’s not even that which is the main problem. It’s actually the stuff about my sexuality I’m most scared about. I thought I was comfortable with it. I thought I’d worked through everything a few years ago when I really went through a crisis of identity. I haven’t. I am fine with coming out knowing the people I am talking to are open minded, but I am not so sure about the rest of the world. More specific I’m not so sure about those closer to me. It doesn’t hurt if some stranger says something horrible, but if it’s someone I know it’s different. I know my mother can be quite homophobic and I suspect her opinions on bisexuality are even worse. I don’t want her to find out. I have always said that she doesn’t need to know and what she doesn’t know won’t hurt her. I suspect other members of my family would be even worse. I just don’t think I can face it.

I realised the other day that I’m not as comfortable as I’d like with my sexuality in general. The other night I was at the pub with a friend and somehow we ended up talking about gay couples. I mentioned a girl I know who used to be in a gay couple and she now goes out with a bloke. She made some comment about him “turning her” and I pointed out that she could be bisexual. She seemed a little taken aback by that and I didn’t know what to say really. It could have been the time to be honest myself, yet I was uneasy with her reaction. I wish I was comfortable enough to be completely “out”, but I guess I’m still not there.

I guess I could always go back and censor myself. I could make any mention of my sexuality private and I’d be safe, yet I don’t want to. I guess I could throw caution to the wind, face my fears and all of that, but I’m not sure I can do. I don’t know what to do.

Urgh…

I feel awful. I don’t know why, but my mood has dropped like a stone.

I saw Dr G this afternoon. I didn’t really know what to say to her. I just said that my week had been “more of the same”, but she tried to probe further and wanted me to tell her how I actually felt. For some reason I didn’t feel able to. I was just vague and didn’t know how to explain things. She asked me about my suicidality. All the way there I’d been thinking about how I could still do it at any point if the opportunity presented itself. Suicide was on my mind. Yet when asked, I played things down. I said that the thoughts were still there, but that some of the time they aren’t as strong as they have been. I said that, when only a few minutes before seeing her they were as loud as ever.

I think most people would be surprised at my suicidality, even now. I suspect that most people think I wouldn’t do it now as I’ve managed to resist for so long. I suspect that most people think things are improving and I am on the way to recovery. The reality is though I am kept safe and if I wasn’t, I’d be long gone.

In some ways maybe I am on the way to recovery. Lamotrigine has been the first medication to not make me worse, and maybe with time it will make things better. My concentration has improved a little and I’ve started to read again, something I wondered if I’d ever do again. I am usually not grappling with the most extremes of my mood any more, although I still have my moments. There are enough encouraging signs to give Dr G and others some hope.

The problem is it is not enough and I still feel hopeless. In many ways I’m still as ill as ever. I could give up on these signs of recovery at any point. I could and probably would end it all given the chance. It may not work and then I’d be back to where I was last February, but I’m certainly willing to take that risk. I don’t care that I may get better. At the moment things aren’t good enough to want to survive.

I am still not sleeping – rarely getting more than a few hours. Dr G has decided that it’s worth trying Melatonin (Circadin). I need to see Dr N to get the script. I hope it helps. Anything is worth a try.

We also talked about how we are going to manage things until I see the NHS. I will continue to see Dr G for now, but I will probably have to be passed over following my appointment with Dr B (or her team) in September (if I make it that far :S). Something I am not overly keen on.

I wish all this could be over. *sigh*