Into the system…

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Posts Tagged ‘life maps

NHS Psychiatrist…

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Bloody hell, the CMHT is in a weird and slightly scary location. The building is a dilapidated old school on a council estate, with rusty railings and dodgy damp portacabins. It was in one of these cabins that I had my appointment. My social worker met me and took me in. The ceiling was falling down from damp. It really shows how much priority mental health care gets within our social services and NHS. Most of the other council buildings are shiny and swish.

It turns out that the NHS psychiatrist I saw today has seen me before, although I wouldn’t have known if he hadn’t have told me. Dr D assessed me in February after my massive overdose and arranged for my admission to the NHS ward back in February. I don’t remember the assessment at all, but vaguely remember his face.

The appointment was fairly routine. He asked me about discharge from the ward, what happened at The Priory, what has happened since. He asked about current mood. He asked about history, self harm, suicide, family history, childhood, education etc. All the usual things. It was a chore going over it all again. The more often I do this history thing, the less I manage to cover and recall. I just skip over things because I have said them so many times I forget what I’ve told who. I think he got the main points though.

He didn’t change my medication at all, as my social worker had warned me. He seemed to think that my current meds were doing some good and that we should persevere. I didn’t know if to ask about Dr G’s planned increases up to 300mg. I think I should have, but I couldn’t find my tongue. He said my meds would be reviewed when I next return to the CMHT.

One positive outcome was a referral to therapy. My social worker needs to get this done, so I’m not holding my breath considering her previous record, but we shall see. He said the waiting list is extremely long, but the sooner the referral is done the better. As I have covered most of the shorter therapies at The Priory, especially CBT, he said they probably won’t bother with these, but he was keen for me to have psychodynamic therapy. He thinks I will need to be in intense psychodynamic therapy for years. I had expected to do some psychodynamic stuff as Dr G had mentioned it in the past, but I thought it would be for a few months. I didn’t think I would need years. I guess I never really saw the whole psychoanalytical, lie on a couch and talk about your childhood thing as for me.

I wonder what issues he thinks I will need so long to deal with. I started on some psychodynamic stuff at The Priory when I did “Life Maps” and I grappled around for some reasons for all of this, but my childhood was uneventful and I don’t know what problems there are to find. I know there are some relationship issues with my mother and I was bullied in primary school, but aside from that I am unsure. I don’t think these are deep enough and I see my condition as largely chemical.

The plan is for me to continue on these meds, wait for a referral to therapy and see him (or someone else on the team) again in around 8 weeks. This wait is better than I’d feared but it still seems a long way away. I find the future so hard to comprehend I don’t know how I will get through to then. I was told to continue to see my social worker and to use the ALERT service, the CMHT in hours, the crisis team or A&E if things get worse, but I don’t know how easy that will be. I tend to suffer in silence and hide how bad things are getting, even now after everything.

I’m glad the appointment is over. I was so nervous and didn’t really know what to expect. The next step is to contact Dr G and tell her what happened. I think she will be glad about the therapy as she had wanted to find me something before. I am scared about letting go of her support, but know I will have to eventually. Dr D seemed a little concerned that I had still been seeing a different psychiatrist and I think he wanted that to stop. I understand it would be complicated. I guess I’ve always got the option of going back to Dr G if I felt I needed it. Dr D asked me to contact Dr G and get her to send a summary of my care at The Priory and a date for which I will be discharged by her as well as a list of the therapy I’ve had at The Priory. It all seems quite final.

p.s. I updated the My Story page today.

Medi-go-up and one-to-ones…

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My Quetiapine (Seroquel) dosage is going up to 400mg. It seems like a lot for someone who is being prescribed off-label and doesn’t have a diagnostic label to match, but nevermind. I saw my consultant again today. It was better than recent visits, perhaps because she has changed something rather than just asking me to wait and be patient, but it is still difficult. I go into my appointments shaking. I seem to lose my tongue and forget what I wanted or needed to say. I forgot to bring up the fact my eyesight has been bad lately and I am still not able to drive, despite knowing I had to. I will have to try and catch her at some point before the Christmas break, but I do not know if she will be in on Friday. She often takes it off.

Anyway, the other revelation of today is that I am being referred for one-to-one therapy at last. I am apprehensive, as I do not know what I am expected to use the therapy for. A few weeks ago, one-to-ones were discussed and it was decided that I wasn’t well enough yet and didn’t really have any key issues that were going to be possible to tackle in one-to-ones. Since then, nothing seems to have changed. I have no idea what I should talk about. I go into group sessions and have no idea what to tackle each week, but I can’t ask for the spotlight to skip to the next person in one-to-ones. I still do not have any answers or even the right questions. I just don’t know where to start. I am lost in this quagmire of shifting moods and negative thoughts. I am still struggling to see much further ahead than the next few hours and I’m still uncertain of what the future brings. I am still depressed more often than anything else and I am still frustrated and agitated. I feel like I am staring at brick walls in all directions and I don’t know which way to turn or how to break through them. I am glad that I am being referred to the therapist that I did my life maps with. I trust her and she seems to understand my frustration and confusion. She understands that I feel trapped in this limbo, not knowing where my diagnosis lies or how to fix the problem. The only problem with this is, I also know she doesn’t know how to fix the problem, so I am unsure of how much use an hour a week with her will be.

I am scared of therapy. It can bring up more things than it solves and it is hard work. I know I need to put the work in if I want to get better and I can’t just wait for medication to do it’s magic, but it is still daunting. Therapy seems to just drag up all these things and makes you question everything. It leaves you sitting in a mess of confusion and not knowing where to start or how to solve it. I don’t know where to begin untying all the mess.

I think most of all I am left feeling frustrated. I am worried that treatment will never work. I only feel that I am more and more confused and the fact that I am doing all the things I am told I need to do to get better and it is not making any bloody difference only adds to the desperation I feel. WHY AM I NOT BETTER!?! IS IT ALL MY FAULT?! WHEN WILL IT BLOODY WORK?!?!!!! WHAT ELSE CAN I DO?! ARRGHHHGHGHGHGHGH!!!

You get the idea.

I…am…fed…up.

Knowing how it feels…

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As Chouette pointed out, it is no secret that I met up with her, Kate, Colouredmind and Eccedentesiat this weekend. It was good to attach real people to the blogs and stories that I read. I enjoyed the meet, however brief for me, but am conscious I was talking far too much. It is a trait that comes from nervousness and agitation, but one I struggle to keep under control. Thanks though. I hope we can do it again.

It was great to just chat about everything and anything. Although we all know how it feels to suffer at the hands of mental illness, it was good that we could be “normal” and talk about other things too. We all know what it is to be students and to live in the city that we met. We all have a life aside from this. I think it is good for all of us to remember that. My partner thinks that I have become too wrapped up in being ill and that I shouldn’t spend all my time with “depressed friends”, but I think doing just that has helped me to remember the other side of life.

That said, I also appreciated being with people that know how it feels. I agree with both Hannah and Chou that we have all lost much to this illness. I too, have a list of wishes and a collection of regrets. I too, wish I didn’t have to take medication to live and sleep, wish I could find enjoyment in things and wish I could erase many things from my memory. I wish I didn’t have to spend days in therapy. I wish I could drive without being a risk to myself or others. I wish I could spend time alone without someone worrying about me. I wish I could turn off the negative thoughts that infiltrate my mind. I wish I could return to the career that I loved and not head straight for a nervous breakdown. I wish I could get on with life and want to live.

I have all these big wishes, but it was weird. The thing that struck me most from Hannah’s post, was the line:

I want to wear my hair parting on the otherside and not have scars to hide underneath my hair

I too wish for this. Worse, I wish I could part my hair anywhere and not show the scars of a lifetime of destruction. This is something I am so ashamed of, yet I still continue to wreak havoc. I have scratched my scalp to the point of bleeding and picked at every scar, every single night, for as long as I can remember. My hair no longer grows in the worst places. Elsewhere, it grows in tufts, as it tries to recover from the abuse. I cannot get a haircut, for fear of what the hairdresser might say when they see the mess that is my head. I am deeply embarrassed by it. My scalp constantly hurts and itches and I can feel the blood in my hair. I hate it, yet I am unable to stop. It is a compulsive act of nervousness, a compulsive act of self-destruction, a compulsive act of distraction. It is worse than ever at the moment. I lie awake at night and give in to the urge to hurt myself., leaving blood on my pillow. I sit in therapy and find my hands wandering. I hope no one notices, but fear that they do. I stand at the mirror and look at the scars. Most of the time I don’t even realise I am doing it, but I am painfully aware of the consequences. I wish that I could stop. I wish that wish was enough and I’d have the willpower. I know that I don’t. It is another one of those wishes, but I think it’s another one that is hopeless.

Yesterday I saw my consultant. I didn’t know what to say to her. I said that I’ve been frustrated that I feel no better. I said that the insomnia has returned. Her only answer was sleeping pills, Phenergan (Promethazine) again. I tried it on the ward and don’t think it helped, but it’s all I can try. I refuse to take Zopiclone, Promazine had no effect on me and Trazodone gave me all the silliness and uncoordination of drinking five pints, then left me with the hangover to match. Diazepam is off limits outside of the ward, as she doesn’t want to leave me with a nice addiction at the end of it all. She looked through her bible of psychotropic drugs at the sleep disorder pages, but didn’t find any other suggestions. Only Mirtazapine, which she discounted with a shake of the head. She went through the sleep hygiene list with me, but she knew better than to push that one. Admittedly, the fact I only had an hour or two’s sleep at most last night, was probably exacerbated by the diet coke I’d been drinking, but nevermind. Anyway, I have a note to give Dr N on Thursday, so my green slip will have the new one on the end.

Back to Dr G. She wants to put up my venlafaxine, but is scared of the consequences. The constant background agitation of the past few weeks makes that seem like a bad idea. She wants to put up my quetiapine, but is scared of the consequences of that too. My chronic apathy and considerable numbness are the issue here. Instead, she has done neither and left me in limbo-land with meds that don’t seem to help. I am fed up of the medi-go-round. I just want them to work. She is waiting and hoping that they kick in soon, but I’ve been on these for over 7 weeks now. Surely if they were going to work, they would be by now? Maybe I need to have more faith. How is the placebo effect going to work if I don’t believe in them? It’s still frustrating though.

She seems to think the way forward for me is therapy though. She isn’t holding out too much hope on the meds front. I wish I had as much faith as she does that splodging some paint around, talking about my life story, or getting annoyed at CBT will do anything to help me. It may be a short term distraction, help me to be more honest with myself and others about how I feel and give me a chance to think about stuff, but at the end of the day I still feel like crap and still battle day in day out with the intrusive thoughts. I don’t know how much “working through my issues” I can take and where it is going to leave me ending up.

I am chronically frustrated with this chronic depression. When will things change? I keep ending up in the same place. I keep waiting for things to improve. I am fed up. I feel like screaming it.

Past Lives…

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Over the last couple of days I’ve been reading a lot of my old online journal entries. It’s weird to read back. I have forgotten so much. So many of my entries talk of nightmares, insomnia and mood swings. I blamed hormones back then, but it does make me wonder; was this just illness, unnoticed? I have posts describing agitated depression right back from being 15. I have other posts describing hypomania, yet I did not know to call it that at the time. I just thought I was happy. Other posts are melancholy. Most of them are monotonous, repetitive and boring, but there is some interesting stuff too. I wonder what my psychiatrist would make of my old diaries. I am going to copy out some of the key entries for my life map. I think it will help to flesh it out with my own descriptions of events from the time, rather than my retrospective ones. I’m cautious about medicalising my teenage mood swings though. I don’t really see how I can put them down to anything but the natural course of adolescence.

Aside from that, I’m not sure how I am at the moment. I was a little on the agitated side again yesterday. I struggled to stay still or focus in group and felt a bit irritable, but generally manageable. Today, I have spent a lot of the day in bed and just been cleaning or reading stuff online. Not exactly a productive day.

I am still a little on edge. I am just waiting. Waiting for things to change. Waiting for someone to help. Waiting for someone to tell me what’s wrong. Waiting for the medication to work.. Waiting to feel better… or worse. Waiting to see what happens next. I just don’t know what’s coming and I don’t know how long I can keep waiting. It’s all the same. It is all so pointless. Why am I waiting?

August – November: Up to now…

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I know I’ve been pretty quiet since I returned to the blogosphere, but I’ve generally been pretty busy with day care and when I haven’t been, I’ve been too ill to write or busy working on therapy homework. Or at least pretending to be busy working on therapy homework.

One of my therapy groups is something called Life Maps. For this session we have to create a “map” of our lives to date, highlighting key dates, events and people from our life story. We can do this however we wish, such as a big timeline, bubble charts or just written as prose, as long as we can use it to explain our story. During the sessions we look at an area of our map and by talking though our story, we can look at the key events that have shaped us and also keep an eye out for repeated behaviour and issues which may or may not have contributed to the development of our illnesses.

Simple right? Haha!! It is hard work. I have barely started to go through things and everything I’ve covered so far seems pointless and unrelated, except the info from the last couple of months. I feel guilty for my lack of progress. I need to look at my teenage years, but I am struggling. My concentration is shot to pieces due to medication and illness and my memory is terrible, so trying to recall events of the past 22 years is not easy. Problem is, I know I can’t use that as an excuse. Everyone else is in the same boat. My perfectionism also haunts me and makes it difficult for me to put things to paper, for fear of it not being right, but I know I need to fight this. I hate that I am not making the most of the therapy offered to me, but I am just not well enough. I know the therapy coordinator was worried I wouldn’t be up to it, but I want to prove him wrong. Problem is, I’m failing so far.

Anyway, I explained how Life Maps works because I decided to try and kill two birds with one stone and type up a potted history of events since I left the blogosphere, covering my path to hospital and beyond.

It has been a crazy few months. This doesn’t really begin to cover half of it, despite the amount of detail I’ve included. I just couldn’t explain how it’s felt to go through all this. It’s been a whirlwind. The future is still hazy. I am still unwell and still waiting for answers. I hate that despite all this, things really haven’t changed all that much since August, when I was last blogging. I just hope that things start to change soon, as I don’t know how much more I can go through before I break.

I’ve decided to do this as a series of posts as it is really long and unwieldy. Below, you can see a number of titles linked to the other posts. I hope this works out okay.

EDIT:– Why are trackbacks so unreliable? If you make a post with lots of links they don’t all ping at the same time. Usually only the first link pings. You then have to keep editing and saving the post until they all work. Stupid thing!

August/September: New GP, New Meds…

September 9th: The Bridge…

September: Caffeine Crisis…

September/October: Meet the Shrink…

October 4th: Tell the parents…

October 7th: Into the hospital…

November 4th: Out of the hospital…