Into the system…

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Posts Tagged ‘Lamotrigine

Too much to say…

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I have lots on my mind and plenty that I’d like to share, but the time and motivation has been lacking. I wish I could just empty my head onto this blog, without having to go to the effort to sit here and type. When I am lying awake at night, I think about what I’d like to post, but I rarely make those posts a reality. It would be brilliant if I could make posts happen just by thinking of them. It would make me a much better blogger and would save me a lot of time. It would give me something to do when I can’t sleep. It would also mean that this post wouldn’t have taken over two weeks to materialise.

So the big news is I’ve started therapy. Or rather I’ve started the assessment sessions for therapy with the new psychologist.

The first few appointments have been okay I guess. During the first appointment we mainly talked about the practicalities of therapy and she updated me on the changes going on in the service (change in Trusts). She asked me a bit about what has been going on for me lately and how I feel therapy can help. I didn’t really know what to say, but found myself talking about the whole diagnonsense malarky. I was scared about getting onto such territory, but I guess the fact I felt able to bring it up must suggest I was relatively comfortable talking to her. I was worried about how she would react but she seemed reasonably sympathetic and supportive of my concerns. I told her I was unhappy about how they were so quick to change my diagnosis to a PD, especially when I was obviously unwell and not exactly demonstrating my usual behaviour. I think she understood, but I don’t know if she agreed as such.

I felt completely exhausted after the first appointment. I had to go straight to work and had a few errands to run and wasn’t in any frame of mind to do so. I was feeling really dazed and found it was impossible to concentrate. I didn’t get anything useful done at work, but at least I didn’t have anything important to do. I got lost twice that afternoon too. Despite looking up directions, I would forget where I was going before I got to the first junction and have to pull over and look them up again. In total, I probably spent over an hour driving in circles on that day trying to find the depot to collect a parcel. One of the places I’d been to hundreds of times before too, which is even more frustrating because I never used to get lost. If I’d been somewhere, I could always find my way back. Not any more.

The second appointment was a lot less structured than the first and felt like it went all over the place. We covered ten billion things, yet I don’t know how much was relevant. It felt like we were skipping over things too quickly and completely missing out others. I guess it is hard to know where to start when there is so much history to cover and so many different layers. The appointment went in no time and I can barely remember anything which was discussed. At the end she suggested we tried to start from the beginning for the third appointment and she asked me to put together a timeline of key events, separated by good times and bad times. I’d done timelines and histories before, but was a bit worried about putting it together again and leaving things out.

So the third appointment was meant to go over my time line, but we ended up talking a little about the second appointment first. When we did get on to the timeline we didn’t get very far. We only managed to cover up until the end of primary school really. She asked a lot of questions, mainly about my family and what life was like as a child. I can barely remember, so this was hard and I didn’t know what to say. I have a few clear memories and a lot of fuzziness. The session disappeared in no time. We’re meant to be picking up on it again next week. Fingers crossed we will cover a little more. There are only two more assessment sessions left.

Aside from therapy I have got very little else done over the past few weeks.

I saw Dr N a couple weeks ago and we discussed the medication question. He hadn’t got the letter from Dr M. He said it usually takes her a while. I explained what her suggestions were and we discussed it. He thinks Quetiapine should be a definite no, which I agree with. He didn’t think it helped me the first time around and as I’m already on the Lamotrigine as a mood stabiliser he is not sure it will help. He was really keen for me to come off the Reboxetine though and was keen to find an alternative. He said that I have been “really quite unwell” since I started it. I know I’ve been struggling a lot with the side effects, but I’d never really considered the physical illness to be all that important even though it is problematic. I have always thought the mental improvement was worth it. When I was so depressed before, it was just a relief to feel different. He is not so sure that Reboxetine is good for me though. He still isn’t even convinced the Reboxetine was responsible for my mental improvement. I don’t know. He seems to like the idea of trying Mirtazapine. He considers it a more effective anti-depressant and thinks it will help with my sleep. We talked about the weight gain and he said I could always stop it if that became a problem. Overall, he seemed to want me to take it and he offered to write me the script, but I wasn’t so sure. I mentioned that the bloke wasn’t keen on the idea and he said that didn’t surprise him. It’s so common for people to want you to take less pills, not more. To be fair, I’d like to take less pills, but I know that is probably not a wise option. I decided I’d like to wait and think about it a while longer though. I also mentioned that I’d got the therapy appointment through and he agreed that therapy may be a reason to hold off making any changes right now. I wouldn’t be able to tell if something was making me worse or know what to blame. So that’s how I left things. I am going to see how the first few therapy appointments go and then decide. I could try and hang on until Spring and then maybe I can manage with a lower dose of Reboxetine again anyway, but we don’t know. It’s another case of “we shall see”. It’s a phrase I seem to use often at the moment.

I had my dental hospital appointment as well a few weeks ago. That was to discuss the TMJ (jaw joint) problems I’ve been having. I had an x-ray and after a long wait the consultant poked and prodded and moved my mouth about, to come to the conclusion it’s a cartilage problem. She didn’t really offer any solutions to this problem, other than the usual stuff. I was aware of the normal management techniques already – identify habits such as nail biting, night-time grinding etc, do some simple jaw exercises and take ibuprofen regularly. She agreed that there was no evidence of night-time grinding from my teeth, so she doesn’t think a splint or mouth guard will help. She did notice that I had short, bitten nails, but I actually tend to pick at them with my fingers rather than bite them. So she’s given me some jaw exercises anyway and I see her again in 3 months.

There was one weird thing about the appointment though. The consultant reminded me an awful lot of Dr Shock, who was in charge of the ECT. Considering I attribute the jaw problems to the ECT, I found this very unsettling. I don’t really remember what Dr Shock looked like, but this consultant was an equally large woman and I remember her voice was very similar. Something about her manner reminded me of her too.

Thinking of ECT, I drove past the hospital today. I have been past a couple of times since I had the treatment and every time I go past I feel a bit weird. I think of the taxi trips over to the other hospital and the strange nervousness that went with it.

Last week I had another appointment with Dr Occy Health. It was a strange appointment, made stranger by the fact he misunderstood me near the beginning and it only become clear towards the end of the appointment that he was mistaken. When I said I was still only working 6 hours a week, split over 2 days, he thought I was working 6 hour days, twice a week (12 hours). This is understandable because it is what we were aiming for. He went through most of the appointment under the assumption I was fine, had met the 12 hour target and we should set a new target of 15 hours by the end of Feb. I didn’t realise until he went to dictate his letter at the end. We had to back track quickly and he said we should just stick to the 12 hour target for now then. He was keen to stress that managing the 6 hours was an achievement, but I felt like I’d let him down a little. He seemed so pleased at my supposed progress, it was a little disheartening to admit I’d not made the target. Admittedly part of the reason for not making that target has been the reluctance to increase the hours from HR. Rehab Consultant Woman happened to contact me when I was at my worst in December and she had been somewhat concerned that I was struggling. It seems she passed this message on to HR, which is why they wouldn’t increase my hours. I hadn’t realised this at the time. Despite the fact I have been struggling a little, I’m not sure extra hours will make it worse. If anything it may even help. I often feel that the 3 hours I am working is not long enough and I try to cram too much stuff into that short period of time. A little bit more time may help me slow down. I don’t know. Then again, I don’t have enough work to fill 3 hours, so how I expect to fill 6 I don’t know.

Anyway, I should sign off. My mood is still up and down and all over the place. I’m managing though for now. Not getting much done aside from work, doctors/therapy appointments and walking the dog, but I am treading water I guess. It is a struggle, but I just have to keep reminding myself I’m miles ahead of where I was this time last year.

I hope everyone else is coping okay. Sorry I’ve been rubbish at commenting and stuff lately. I’m trying to read what I can, but I am also trying to step away at the same time. I find myself losing time and unfortunately reading blogs seems to eat time pretty quickly, so I am holding back until I can find the time.

More of the same…

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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.

Diagnonsense…

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This post is inevitably going to be very long. I have been thinking about what to say for days now and I just haven’t been able to force myself to do it. I need to write though as I must get this straight in my head.

I seem to have writers block. I sit down here with the intention of writing and making sense of everything and I can’t do it. I try to put all of these thoughts down onto the screen and I can’t. There are too many conflicting worries. Too many fears. I know what I have to say, but I am scared. I am scared of writing for making it real.

As you may have read, there was talk about changing my diagnosis when I was first admitted. I was a little surprised and worried about this to say the least. It was hard enough getting a firm diagnosis the first time, let alone having to go through it again. I had accepted the Bipolar II diagnosis and was felt it was accurate. I’ve not found any other diagnosis that describes my experience as well, although I do accept there are so many overlaps between psychiatric diagnoses that it is possible to get things wrong or mixed up.

I am uncomfortable with the idea that Dr M seemed to decide I didn’t have Bipolar Disorder in about 10 minutes. She referred me to Dr S, who is a consultant psychiatrist specialising in psychotherapy. She’s involved with the EDT team that I have been waiting on since last year.

Dr S assessed me over two, hour long appointments. Dr M wanted someone with a therapeutic background to assess me and provide input on my diagnosis. Dr M was obviously considering a personality disorder, although amazingly it seems not the one I thought she was (BPD). I am starting to wonder though how much Dr M influenced Dr S’s assessment.

Dr S asked me about all sorts of stuff. We did the usual history thing and she dug deeper on some things. She asked me a lot about my mood. One thing I was uncomfortable with was the constant assertion that my experience of high moods, could just me not recognising normal moods because I spend so much time depressed. I don’t agree with this. It is not normal to be working 16 hours a day, hardly sleeping yet not tired at all, running around your office doing a million and one things, laughing and talking constantly and generally not being able to concentrate on anything.

At the end of our second session, she told me what she thought. She agreed that I had “some form of mood disorder” but wouldn’t commit to anything. She told me that she was leaning towards recurrent or chronic depression rather than Bipolar II disorder, but wouldn’t dismiss that completely. She also mentioned “personality traits” (mainly perfectionism and high standards) that she said perhaps made me more susceptible to mood episodes, but she also said she didn’t think there was enough to suggest a full personality disorder diagnosis.

So what did Dr M think? I tried to find out, but she kept avoiding the subject. With regards to mood, she did mention dysthymia at one point, but surely by definition dysthymia would never be severe enough for hospitalisation? There were times when she even questioned whether or not I was, or had ever been depressed, which seemed bizarre.

When asked about the personality side of things she said she  “didn’t want to open any boxes that can’t be closed”, implying that it could be dangerous to give a diagnosis without being certain. She said there were personality traits which she was concerned about, particularly focussing on “high standards”, but she didn’t feel any were severe enough to consider a full PD diagnosis. She would also tell me that labels weren’t important and that we should focus on trying to “change the way I see the world”.

I saw Dr N a couple of weeks ago and he said my diagnosis had been changed on the system. This sparked my curiosity because I couldn’t get Dr M to commit to anything. I asked him what it said and he looked it up. It just said “moderate depression” and “personality disorder”. Nothing more specific than that. I think we were both curious as to what PD, although I think he suspected borderline too. After all, he had even suggested it back when he first met me, but it hadn’t been mentioned again since.

I saw Dr M again last week. We got through pretty much the whole appointment before I eventually found an opportunity and the courage to ask about my diagnosis. She had to look back through my notes to find it, which is a little scary. You would have thought she’d know what diagnosis she had given me.

It states clearly:

  1. Moderate Depressive Episode
  2. F 60.8 Other Specific Personality Disorder.

I have issues with the first diagnosis, but didn’t express them because I was so surprised and concerned about the second point. I didn’t know what F60.8 actually said, so I asked her what PD she referred to and she mentioned Narcissistic, which I was surprised about. Of all the PDs I had considered she might give, it was not that one. I told her this and she just said that she “felt the signs were there” and that Dr S agreed with her. I told her what Dr S had said to me; that there were some unhelpful personality traits and that I accepted those, but also that either of us didn’t think any constituted a full personality disorder diagnosis. Dr M then tried to justify her decision by saying it was not the primary diagnosis, but that if she thought it was there it should be documented. Somehow she seems to have decided to open the box after all.

I wanted to question how helpful any personality disorder diagnosis would be, let alone an inaccurate one, considering there aren’t any specialist services or extra treatment available here, but we had already gone well over my time and I didn’t have the fight or words to argue.

I want to argue though. I want to fight. The more I have read and the more I think about it, the more unhappy I am about this diagnosis. It doesn’t seem accurate and really doesn’t seem helpful.

I am less concerned about the depressive episode diagnosis, although that has its problems, but the personality disorder diagnosis is really concerning me. I find myself offended and ashamed by it. No one wants to be considered self-serving, unempathetic and arrogant. I think the shame has actually been one of the barriers to posting about it. I don’t even want to put my name near the diagnosis I’m so unhappy about it. The fact it is written in my notes for posterity is disconcerting to say the least.

So what is wrong with this diagnosis?

Firstly “Moderate Depressive Episode”.

If you consider the ICD-10 explanation of this diagnosis, F32.1, you have to note that by referring to a depressive episode you are implying that it is the first episode of depression. For me this is far from the case and I don’t like that my diagnosis neglects to consider any past mood episodes. It is almost as if she doesn’t believe I have been depressed before.

I also question the severity, but I understand that this can be subjective. Many people would go off my BDI score, which is still above 40 (severe depression is considered 30+). I do have more than four of the ICD-10 listed symptoms, but I would also suggest that some of these symptoms are marked and distressing, making it severe. Actually attempting suicide would surely put the suicidal ideation into distressing territory? Worthlessness, guilt etc are all pretty marked too. The thing is I still function reasonably well so people can be forgiven for thinking I am better than I am. It also doesn’t matter. The treatment for a moderate episode varies little from a severe one and it doesn’t make much difference whether it is my first episode or 10th.

What about the lack of acknowledgement of hypomania or high mood? The treatment for Bipolar II Disorder is different to that of Major Depression. I have responded much better to the introduction of Lamotrigine as a mood stabiliser than I did to any antidepressant to date. What if they try to take me off this? Would I respond better to a different one and will they ever try it? Usually antidepressants make me agitated and unstable. I have been okay with the Reboxetine so far, but it doesn’t seem to have lifted my mood at all, so what will happen if they change it? What if I am given an antidepressant that sends me skyward? It worries me.

At the end of the day though I am depressed at the moment and that’s the important thing. It’s the other diagnosis I’m most concerned about.

So – F60.8 “Other Specific Personality Disorder” (Narcissistic).

The ICD-10 does not give individual diagnostic criteria for the disorders listed in this category, so I will assume that the DSM-IV criteria is what Dr M is referring to, after all she had a copy of the DSM on her desk when I saw her.

The criteria for Narcissistic Personality Disorder is as follows:

A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

  1. has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
  2. is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
  3. believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)
  4. requires excessive admiration
  5. has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations
  6. is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends
  7. lacks empathy: is unwilling to recognize or identify with the feelings and needs of others
  8. is often envious of others or believes others are envious of him or her
  9. shows arrogant, haughty behaviors or attitudes

It is also a requirement in the ICD-10 that any specific personality disorder diagnosis meets the general diagnostic criteria for personality disorders.

According to ICD-10, the diagnosis of a personality disorder must satisfy the following general criteria, in addition to the specific criteria listed under the specific personality disorder under consideration:

  1. There is evidence that the individual’s characteristic and enduring patterns of inner experience and behaviour as a whole deviate markedly from the culturally expected and accepted range (or “norm”). Such deviation must be manifest in more than one of the following areas:
    1. cognition (i.e., ways of perceiving and interpreting things, people, and events; forming attitudes and images of self and others);
    2. affectivity (range, intensity, and appropriateness of emotional arousal and response);
    3. control over impulses and gratification of needs;
    4. manner of relating to others and of handling interpersonal situations.
  2. The deviation must manifest itself pervasively as behaviour that is inflexible, maladaptive, or otherwise dysfunctional across a broad range of personal and social situations (i.e., not being limited to one specific “triggering” stimulus or situation).
  3. There is personal distress, or adverse impact on the social environment, or both, clearly attributable to the behaviour referred to in criterion 2.
  4. There must be evidence that the deviation is stable and of long duration, having its onset in late childhood or adolescence.
  5. The deviation cannot be explained as a manifestation or consequence of other adult mental disorders, although episodic or chronic conditions from sections F00-F59 or F70-F79 of this classification may coexist with, or be superimposed upon, the deviation.
  6. Organic brain disease, injury, or dysfunction must be excluded as the possible cause of the deviation. (If an organic causation is demonstrable, category F07.- should be used.)

I guess you can draw your own conclusions from reading the criteria and what you know of me from reading here. I guess others may have a different opinion of me, but I hope they can see that this is not what I am like.

I have decided to go through each point of the NPD criteria myself to see if I can work out what does and doesn’t fit.

1. Self Importance

has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)

I really don’t think this is the case. I often downplay my achievements, because I can actually find it hard to admit them, even recognise them. I was bullied at school for being clever and a “swot”, so I am not really comfortable with admitting my successes to people. Yet when I’m assessed by mental health professionals I do of course have to talk about my achievements and talents, so I guess they can be forgiven for not realising this. It’s hard not to talk about these things when you are asked to give your life story. I have a good job, which I have been successful in, I got a 2.1 at university, I got 3 As at A Level, I got 11 GCSEs including 4A*s and 4As. These are facts though, not exaggerations.

I don’t believe I am superior, certainly not to anyone with equivalent achievements. Most of my colleagues at work have a similar background to me and I certainly don’t consider myself superior to them. Yes, my academic record is superior to someone who left school with 3 Cs at GCSE, but that doesn’t make me superior; just better at school.

I think this is hard when you have been generally successful. You can seem like you are bragging when you are not, it’s just the truth. I remember during the assessment with Dr S there was a lot of focus on my achievements and suggestions that considering my age I had done well. I generally agreed with her, but now I almost wonder if she was fishing for this.

2. Grandiose Fantasies

is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love

I don’t even believe in unlimited success or ideal love so how I can be preoccupied by fantasies of these things, I don’t know. When Dr M and Dr S had been talking about high standards, they actually seem to mean in this sense, rather than the perfectionist sense, which I didn’t realise until this diagnosis was made. So I’ve been agreeing with them when I actually disagree. They seem to think I expect to be highly successful and powerful. I don’t. In the past I had been fairly ambitious, expecting to do well at school and going on to get a good job, but I don’t expect “unlimited success”. Anyone with a good academic record starting out on a career similar to mine has similar expectations. This is usually something to be considered positive and not out of the ordinary. Now of course I’m depressed and even the most simple tasks seem ambitious, which would suggest that these thoughts aren’t pervasive either, therefore not meeting the diagnostic criteria.

There was a short period fairly recently where I had thoughts of going into politics as I wanted to make a difference and there was a lot of focus on diversity in politics and increasing the number of women in parliament. I can be passionate about issues and want to do something about them. I guess I may have been fantasising a little at the time, but even still this is not an unrealistic ambition. I have been interested in politics for years and often considered it as a future career option, but not because I want to be all powerful.

I have had the odd grandiose moment when my mood has been high though and I have admitted this. Of course they question whether or not I’ve ever experienced hypomania, so will put this down to personality rather than symptoms of a mood disorder.

3. Special Status

believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)

This is one that I guess I can identify with, although I am not sure it is correct. I do not believe I am special as such, but I guess I do feel more comfortable with people that have a similar background or interests to me. I think everyone does though to some degree and it is not like I will not associate myself with other people. I try to judge people on their merits and will talk to anyone.

I can see why they may think this is true though. During my assessment with Dr S she asked me about my regrets regarding me degree choice. She asked about how I chose my course and one of my considerations was choosing a respected university. This consideration was mainly to keep my career options open as opposed to anything else. There are plenty of graduate employers that only recruit from top universities. I guess this could be seen as wanting to be associated with “high-status institutions” though, so they may well use this as an example when diagnosing me.

4. Admiration

requires excessive admiration

Erm. I don’t know how to reply to this. I cannot deny I can have difficulty responding to criticism and that I like praise, which I guess may come under this category, but I don’t require or seek excessive admiration. If someone likes me that’s a bonus, but if they don’t then fine.

5. Entitlement

has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations

A sense of entitlement? I expect fair and reasonable treatment, but I don’t expect favourable treatment over others. I am a strong believer in equality and a sense of entitlement would go directly against this.

I can at times be stubborn and this could be misconstrued as expecting compliance with my expectations. I will compromise, but I try to be assertive as well. I don’t see this as entitlement though. We are usually encouraged to be assertive when in therapy, so it would be wrong to judge this as being narcissistic.

6. Exploitative

is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends

It is criteria like this that makes me so uncomfortable about this diagnosis. I don’t want to be considered self-serving. I don’t take advantage of others in order to get ahead and I find it horrible when people do. Some of examples given are things such as dressing provocatively to get your own way. Ignoring the fact that if I dressed provocatively people would run to the hills, I would never do this. I hate the idea on too many levels.

7. Lacking Empathy

lacks empathy: is unwilling to recognize or identify with the feelings and needs of others

There are two sides to this for me. In many ways I am often considered too empathetic. I consider other people’s needs often to the detriment of my own. I was told off repeatedly by the therapists at The Priory for considering everyone else first, for listening to the others and offering them advice and support, but for not giving myself the opportunity to speak and receive that support back. I would like to think that I understand how others feel and that I am sensitive to their needs. I certainly try to be, so I am not unwilling.

Yet, I know occasionally my bloke finds I have a lack empathy towards him. He says I don’t realise how much the things I say and do hurt him or recognise how he is feeling. I think our relationship is an isolated case though, because there are many ways in which I act different with him than I do with others – lack of assertion is another.  I also don’t think depression helps matters much. I guess a suicide attempt could be seen as not taking other’s feelings into consideration, but if you knew how much I worried and obsessed over this beforehand you would realise it is not.

8. Envy

is often envious of others or believes others are envious of him or her

I think everyone gets jealous now and again. I can be envious of others that have recovered from illness, because I wonder why I have not. I can be envious when someone gets better grades than me at school. I can be envious when I see people having a great time when I am depressed. I wouldn’t say it is often though and certainly no worse than most.

I really don’t believe anyone is envious of me. There would be no reason to be. I’m depressed. My life sucks!

9. Arrogance

shows arrogant, haughty behaviors or attitudes

I hope I don’t, but I guess at times I can be a bit of a snob and I’m guilty of generalisations. I am not exactly appreciative of chavs and I can sometimes be a bit rude towards people that watch rubbish on TV, but I’m not alone on this. I don’t think I’d go as far to say that this is a major problem or that I was particularly bad at it. I certainly know people who are worse than me!

_______________________

Anyway.  I’m going to post this now. It’s not really complete. There is plenty more I could say on the matter, but I’ve been at it for hours and if I don’t post it now it may be days before I do finish it. Maybe I will edit this post, or maybe I’ll add another. We shall see. This is well over 3500 words long now and I have spent quite a few hours on it.

Does anyone have any ideas of what to do next? I just feel a bit lost and trapped. I’m worried that if I question the diagnosis, it will come across as narcissistic! That is the biggest problem with personality disorders. Questioning it is just further evidence of the disorder and can all be seen as part of the problem.

Face the Music…

with 11 comments

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.

A long week…

with 8 comments

A lot has happened in the past week. I kept meaning to write, but time got away from me.

I saw Dr G last Tuesday and was disappointed. It was a fairly pointless appointment. I did mention my dip in mood in the weeks prior to seeing her, but she didn’t have much to say. She increased the Lamotrigine again by the minute amount of 25mg, so I’m now up to 125mg b.d. She asked me about the hand over to the NHS. She seems ready to hand me over and doesn’t seem to want me to continue seeing her once I’m in the hands of the NHS. She thinks it will complicate things, which it would, but I trust her a lot more than I trust the NHS and I appreciate the constant input. I’m worried about the frequency I will be seeing the NHS psychiatrist. Talking about this with my social worker today, she said that if people are “stable” they will only see the psychiatrist every 6 months, even if that stability isn’t a particularly nice state to be stable in. She said I may see them a little more often at first, but even then it may only be every 3 months or so. This terrifies me. At the moment I always have that “if I can get through the next fortnight until I see Dr G, things may be okay”. This can keep me going. Knowing I’m on my own for months may be enough to make me give up again. I know I can ask for a rapid access appointment if things get scary, bad, but I’m not sure that’s enough and I can’t be asking for one every month or so!

On Tuesday night I learnt the bad side of knowing lots of people with mental health issues. One of my friends who I met in The Priory texted me to thank me for being her friend and to apologise for the fact she was going to kill herself that evening. I didn’t know what to do as I felt powerless to intervene and hypocritical for wanting to do so. She had been a long-stay patient in hospital and I believe was on overnight leave at the time. In the end I contacted the hospital she had been at and told them what she’d said. They wouldn’t discuss it with me due to patient confidentiality or even acknowledge what I had said, but I hope it alerted them and was of some help. They told me to call the police instead as they would have the power to intervene, but I didn’t want to do that. She tried to call me a couple of times in the evening but I missed the calls and when I called her back she didn’t pick up. I was worried but I did what I could. I was relieved when she later texted to say she had been picked up by the police, although worried for her. The hospital she had been in have chucked her out, presumably for breaking the rules of her overnight leave. I’m shocked and appalled by this decision as she’s at her most vulnerable at the moment. The people who are meant to be caring for her have dumped her when she needs them most and she is now alone and extremely ill. Last I heard she was staying with some friends and I just hope they can keep her safe.

This whole thing was triggering for me. I wanted to help her and intervene with her decision, yet I myself wanted to do exactly what she was doing. I was jealous of her at the same time as worried for her. I was angry at myself for being so hypocritical. I knew that if I was in her position I’d have been frustrated if she had intervened, but then I still wanted to do something. I couldn’t just stand by and let a friend die. I was comforted by the fact that she had contacted me. It suggested to me that she wanted someone to do something. She’d have gone alone and quietly if she was completely determined to succeed.

Wednesday started with a trip to Dr N so he could steal my blood for the mood disorder research. He struggled to get anything out of me. Spent ages trying to find veins in my arms and used my wrists in the end. The first attempt failed and has left me with terrible bruising and some wrist pain. The second attempt was eventually successful, but painful as he pushed the needle around in my wrist. We got there though in the end.

After this it was a trip to my office. My work laptop was due to be upgraded so I had to go drop it in to the IT department. It was weird to be in my old work environment. It made me realise that I really missed it. I wish I could just go back and do my job.

I had Creative Remedies in the afternoon. It was visual arts this time, which boils down to painting. I was disappointed by the class as it is restrictive. We had to start with a “colour wheel”, which made me feel I was in primary school. I know very well which colours mix together and what primary and secondary colours are. For our first project we have to choose images from a selection of Japanese, Egyptian and Art-Deco pictures and use these as inspiration. It feels very much like art at school, which is frustrating as I’d rather paint whatever I liked. I was impressed with the materials on offer though. We get a portfolio folder and sketchbook, access to good quality acrylics, watercolours and gouache paints and canvasses to work on. It’s all free so I can’t really complain. The teacher does seem to be experienced and the outreach workers are the same as on Monday’s session, so we should be able to develop a good relationship with them. I’ve been getting on well with one of them in particular already. It is basically just an art class though and not art therapy at all and although it gets me out of the house and doing something it doesn’t seem therapeutic. I miss the emotional freedom of art therapy at The Priory and the therapists there.

Wednesday evening saw us heading over to Snowdonia for a few days camping. My parents and grandparents had rented a cottage over there for a week, so we joined them for a couple of days. It was nice to get away for a few days, but I was feeling a bit flat a lot of the time. A good campsite near Beddgelert, we enjoyed nice food at The Goat Hotel on Wednesday evening.

The highlight of Thursday was a trip to Harlech castle, but a further reminder of my illness. Disabled admission was one such reminder. A bonus in that it was free, but even still I feel weird asking for it. I find it hard to think of myself as disabled. The second reminder came from climbing the towers. I felt uncomfortable at those heights. I am not scared of heights in any way, but I wanted to jump. If my parents and partner weren’t with me it would have been a huge temptation. I don’t think I could do that in front of them though. The image of my fall would haunt them for too long. Aside from this though it was good. I’ve never been such a big fan of ruined castles, but the views were fantastic.

Friday brought beautiful weather and a trip to the beach. We struggled to find one where our dog was welcome, but eventually stumbled across a beautiful little cove, with golden sands and shallow water. The beach was almost deserted with just one other couple there most of the time. We went for a swim, which was of course cold, but good. It was lovely to see our puppy swimming properly for the first time. I felt like a proud parent. There were also lots of little silver fish swimming around, which was unusual but made me a little squeamish.

We came home on Saturday, amidst drizzle and murkiness. A real downer after the lovely day on Friday. Our tent was soggy and I hate packing at the best of times, so I felt pretty awful. I’ve just felt pretty low all weekend and have had little motivation to do anything. I just want to hibernate really.

The highlight of today was another trip to Creative Remedies. I have enjoyed it and I think I will continue to, but I am still unsure of the therapeutic benefit. I wonder whether the vast amount of money that is being spent on this should be put to better use elsewhere, especially in reducing the waiting lists for other therapy.

My social worker came over today to check up on me before we both go and see the NHS psychiatrist tomorrow. She had some paper work to read and sign – mainly my risk assessment and enhanced CPA. It was weird to read a catalogued list of risks and declarations of my suicidal thoughts. She asked me what I wanted from the appointment tomorrow and tried to set some expectations. It seems that we will go over history and recent mood. It is apparently unlikely that the psychiatrist will change my medication on the first meeting and it is likely that I won’t see them again for a while. I don’t see the point in just going over my history and not actually doing anything. He can find the history in my notes and I’d rather use this appointment to make some changes that may help me to recover. We will see though. Wish me luck. I really fear I am going to need it.

Mad Men…

with 7 comments

Again it has been 10 days since I last wrote. I don’t know where the days have gone.

I saw Dr N last Thursday. Just a routine appointment to pick up my scripts, but it was good to talk. He asked the usual questions. Mood, suicidal thoughts, self harm etc. He seemed concerned. More so than in recent appointments.

He pointed out that he could see my scalp was in a bad state. As well as the trich, I also struggle with skin picking or Dermatillomania to give it the technical name. My scalp gets the worst of it. Every day, usually at night, I pick and scratch at my head until it bleeds. It’s covered in terrible wounds, some a few centimetres across. My hair hides the worst of it, but it’s got so bad that it can be seen at the moment. It’s always worst when I’m not sleeping well as I tend to lie awake scratching my head to distract myself from the insomnia.

I have done it for years, longer than the hair pulling even. I think it started when I had chicken pox as a child and I would itch my head. I was maybe 8 or 9? I can’t really remember.

I was shocked that Dr N noticed and mentioned it. I’d confessed it to him a long while ago, but he had never brought it up before. I tried to change the subject pretty quickly and felt uncomfortable that he had seen.

Both the skin picking and hair pulling make the hairdressers a nightmare. My hair is thin in places and there are bits where it is really short where I’ve damaged the scalp so badly it doesn’t grow properly. The scars and cuts are awful and would make most hairdressers flinch. I’ve been asked what has happened so many times and I don’t like making up lies, but I’m too ashamed to tell the truth. One hairdresser even insisted on putting on gloves when she saw the wounds, too afraid to touch them. I last had my hair cut when I was in The Priory, knowing that the hairdresser there would be understanding. I often go over 6 months between a hair cut and it’s been a year before. I try and avoid it as much as possible, even if that means my hair looks rubbish and gets far longer than I’d like. My hair really needs cutting, but I just can’t face it.

Other than the trip to the GP, very little has happened. I’ve spent lots of time watching back to back episodes of Mad Men. If you haven’t seen it, it’s an American TV series about advertising executives during the 1960s. Over here it has been shown on BBC Four, but that doesn’t mean it’s dull and serious! I loved it the first time round, but I watched a lot of it whilst I was in The Priory and ECT has erased most of it from my memory. Watching it again has been a little weird as it brings up memories of those times. I started watching it again because I saw that Series 3 has started in the US now. Will be good to have more to watch. It kills a few hours and takes me away from this world for a little while.

In other news, my bloke may be going back to work a little part time. He left his job to care for me since I came out of The Priory last May. His replacement has quit suddenly, so his old employer have asked if he can do a few hours until they can find someone else. He went in on Tuesday morning, but hasn’t been in again yet.

For me, this is quite exciting. I feel that I am getting a little independance back, being left alone for a few hours. I miss the time I got to myself when he was at work. It is hard being together 24/7.

It is a challenge though. I am still fighting the thoughts and the time alone makes them harder to ignore. It feels like tempting the devil. The monster tells me that “you can do it now, you know you want to”. Over the past few months I’ve had little opportunity to act on my suicidal thoughts. These few hours alone change that and I know there is a risk. My bloke worries about it and I don’t want him to, but I know his worries are justified. I wish I could give him a 100% guarantee that it won’t happen, but I don’t think I can. I am in control to a point and will fight as much as I can, but I can’t guarantee that I will win. The thoughts are intrusive and often impulsive and I know I could act on them before I even think about it. They can spiral out of control and it can be hard to stop yourself when you get to a point. I know I need to hit the panic button before things get that far. I’ve told him I will, but I can’t even guarantee that.

Despite the risk, I still want him to go. I felt bad that he left his job for me as it is. I want him to be able to work again. I can’t be watched 24/7 forever. I am going to have to take this step eventually and it might as well be now. I could be waiting the rest of my life if I waited for the thoughts to go away. I don’t want to let the thoughts win. If he stays at home with me I am doing that. I am letting the thoughts control my life.

Generally I’ve been pretty low over the past few weeks. I’ve been lower, but not much lower than this. I am carrying on, because I don’t know what else to do, but it’s a struggle. Most of the time I just feel so empty and numb. There are still a few better moments, but less than there were a month ago and the average score is down. There are still worse moments too. Fits of rage, agitiation, arguments. There’s this little bubbling pot and occasionally it boils over.

I am disappointed that improvement has stalled. It feels like I am failing. Maybe I’m not trying hard enough to get better. Maybe I am just stuck in depression. There had been seeds of hope, but I am not sure they will propagate. I don’t want to give up on the Lamotrigine as it has been far better than anything else I’ve tried, but it’s just not doing enough. It seems I am heading into a long period of mind-numbingly dull depression, with only the occasional painful period of agitiation thrown in to liven things up. I guess I am already there and I don’t see any way out yet. I don’t know what all this means. I guess I will have to talk to Dr G when she’s back from holiday and see what her thoughts are. I suspect she may eventually give in and resort to the Lithium. She’s threatened it often enough.

I don’t have all that much coming up to look forward to.

Like Seaneen, on Monday I have someone turning up to interview me for the Cardiff and Birmingham Universities’ Bipolar Disorder study. I am a little scared about going over everything and hope it won’t make my mood worse. I feel forewarned having read Seaneen’s post, so it may be a little easier, but it’s true that it isn’t fun for anyone reliving your worst moments. I do think it will be interesting though and I definitely want to support research where I can so hopefully it will be okay.

I see the chocolate teapot again on Friday 11th. She’s actually done some stuff at last. I finally got the referral through for the ALERT service (Out of hours telephone support). They haven’t called me to give me the number yet so I can’t use it, but at least she’s contacted them. I also got the dates through for the Creative Remedies groups. I start on 16th September. There’s a performing arts group and a visual arts group, both lasting 2 hours a week, so that will give me something to do.

I’ve also got a wedding to go to on the 12th, my NHS psych appointment on 22nd and an ESA medical on the 24th. I’m really dreading the latter. I am scared they are going to tell me I’m not ill, I’m just making it all up and I should go back to work. I’m scared they will think I’m a fraud. I did the questionnaire really quickly and sloppily as I just wanted it over and I’m worried now that I didn’t say enough. I have read so many horror stories lately that I am quite worried, but I just hope I can get through it. I am claiming under the youth rules as I haven’t paid enough NI and can’t claim income-related due to my bloke’s savings. Unfortunately they didn’t take the youth rules into account at first and rejected me, so I’m having to appeal. Usually you only get a medical after you have been claiming for 3 months and although it is over 3 months since I applied I haven’t been paid a penny yet due to the appeal. I just hope it gets sorted out soon. Benefits are a nightmare. I don’t see how anyone gets away with claiming when they are not entitled. It seems that most people who are entitled can’t even get them.

Anyway, enough for now. If I posted more often they wouldn’t be such mammoth posts. I shall try.

Short Pause…

with one comment

It’s been 10 days since I last posted. Each time I keep thinking I should start writing more often again, but it doesn’t seem to happen. The gaps seem to get larger, not smaller.

I often think of things I want to write about, but I don’t seem to translate those thoughts into posts. I wanted to write about the NHS when the #welovetheNHS campaign was in full swing, but now I can’t really remember what I wanted to say and the moment has passed.

The last week or so has been up and down. A phrase I say so often.

I went to my parents for a few days last weekend. On Monday my sister, the dog and I trecked over to Porthcawl for the day. It was lovely weather and we enjoyed a splash in the sea, some fish and chips and icecream. Not a bad day really.

Tuesday involved bringing the dog home on the train. It was stressful, but we managed to get back safely. She slept a lot of the way taking up most of the aisle.

I saw Dr G on Wednesday. She increased the Lamotrigine again. I’m now on 125mg Mane, 100mg Nocte. Again it was an increase I expected. She is increasing the Lamotrigine by 25mg every 2 weeks. I wonder if it’s worth seeing her each time or if I’d be better off asking her to give my GP the instructions to increase it, thus saving myself some money. Seeing her every 1-2 weeks is not cheap.

I can’t remember what else we talked about. I remember her telling me she still thought it was too early for me to go back to work. Disappointment and relief. Disappointment that I am not well enough to go back. Relief that I don’t have to make the decision yet and that I am not being forced to go back too soon.

My social worker is still useless. I saw her on Thursday after forgetting I was meant to see her on Tuesday. She turned up at my house and I was at my parents 140 miles away. I guess that makes me useless too.

Anyway, we talked for a little while. She asked me if I’m interested in the creative remedies therapy group and the “positive thoughts” group. She’d forgotten to bring the information again so I’m not entirely sure what I’m letting myself in for. I agreed to both though so we shall see what happens. I’m pretty skeptical about the positive thoughts one. She said it’s simplified CBT, which rings alarm bells, especially as I’ve done non-simplified CBT in the past. I have visions of us sitting in group having to repeat affirmations. The groups are meant to start in September.

J came up with excuses about her failure to complete the referrals so far saying that the problem is she’s useless at doing paper work. More alarm bells ringing when she said that. I’m sure form-filling must be a huge part of her job so I wonder why she’s doing it if she can’t be bothered. I hope she does the referrals but I’m not holding my breath.

She also told me she’ll be with me at my psychiatrist’s appointment in September. I don’t want her to be, but I guess I have little choice. I’d rather I was on my own. I generally find I’m more comfortable with the psychiatrists and I have no trust in her at all, so I think I will find it hard to be open.

She didn’t think my appointment was with Dr B because the time doesn’t correspond to one of her clinics. I’m not surprised at that, but still a little disappointed. She did say who she thinks it will be but I can’t remember his name. Apparently he’s quite new and she doesn’t know what he’s like, which is a little worrying, but I get the impression that is quite normal with the NHS.

The rest of the time lately has been littered with arguments and random drops in mood. Friday evening was difficult. After a long argument with my partner I became hysterical and couldn’t stop crying. I find myself wanting us to break up and these episodes only make that wish stronger. I don’t know how we can carry on like this. The arguments are frequent and pointless. They just hurt us both and make life so difficult. I want to isolate myself from it all. It fuels my desire to not be here.

Earlier today I read this post on mentalnurse.org.uk. It talks of the anger at being saved from suicide. I still feel that anger and unlike Torah, I am not pleased to not be dead. I still wish that I had not been saved. I remember the disappointment of waking up and knowing I’d failed. I remember people asking me if I was glad to be alive and thinking they were insane. I still don’t understand how they could ask that. I didn’t make the decision lightly. I knew I didn’t want to be here anymore and failing to complete my plan did not change that decision. It’s still not changed that decision. I still want to be dead.

That’s not to say my suicidal ideation has not lessened. A few months ago I was constantly actively suicidal. Always thinking of plans, always looking for the next opportunity, always battling the thoughts. Now my thoughts come and go, but they are still a frequent annoyance. I have moments when the thoughts lessen, but I am never glad to be alive. Most of the time I’m still wishing I was dead.

I do not see the point in life, nor the appeal. I don’t understand anyone who is glad to be alive. I see life as a long hard battle with no positive outcome at the end. I don’t see why anyone would put themselves through that for any longer than is really necessary.

I don’t know what will come of these thoughts. I have managed to resist over the past 6 months, but I do not know how long I can keep this up. I have been kept safe for most of that time, unable to act when I have most wanted to. That supervision will of course continue while I still harbour the desire to be dead. I wish it wouldn’t but know I can’t stop them. There is anger there of course. An annoyance that I am not in control of my own life. I understand their reasons though and I know I have no choice but to comply. I just wonder how long for.

I wish that things will change. I wish I could find a zest for life. I wish that I could see a point to it all. I wish that there was enough hope to keep me going.

I find myself wanting to force the change, but I can only see one option for that and I know it’s not the one that everyone else desires. I worry that I will take that option regardless. Suicide is always the fall back position. My trapdoor to escape all of this.