Into the system…

blogging, work, mental health, therapy, disability, benefits and more…

Posts Tagged ‘mood swings

Bombshell…

with 16 comments

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Days pass by…

with 12 comments

I’ve been wanting to write for days now, but not got around to it. Things keep coming up or I get distracted.

I saw Dr N on Friday. It was the first time I’d seen him in weeks. First there was the secretary screwing up incident, then I was at Glasto and then he was on holiday for a couple of weeks. I’d missed him, but we didn’t have long to catch up, as is the norm with GP appointments. I told him I’d met my CMHT worker. When he asked if she was a CPN, he was pretty surprised and seemed disappointed when I said I had a social worker instead. I don’t think I’m the only person to be sceptical about the usefulness of a social worker. I left soon after with a new sick note and a couple of scripts.

On Friday night I took the increased Nitrazepam dose (20mg)  for the first time. Had a night of restless sleep, but more than I had been getting before. The problem is it sent me bat-shit crazy.

I woke up in the blackest of black moods. Far worse than anything I have experienced of late and that is saying something considering my mood over the past few months. My mind was focussed on one thing and I was agitated, irritable and highly emotional. I woke up with a splitting headache and generally felt terrible. I spent most of the morning in bed, virtually unable to stand my head hurt so much and completely unwilling to face the world.

In the afternoon, my bloke insisted on dragging me out to The Peak District with the dog. I felt awful and was not in the mood at all, but didn’t have much choice in the matter. During the walk I was angry and upset and unable to control myself. I was crying and shouting and taking everything out on my partner. At one point we stopped at a bench, my bloke determined to talk to me and find out what was wrong. I was pretty much screaming at him that I hated him and just wanted to throw myself off a cliff. There was one point when I realised that we were close to a steep drop down to the reservoir below and I walked straight at it contemplating a jump. It was enticing me, calling to me. I don’t think it would have worked, but it was all I had at the time. My partner was quick to respond, realising what I was considering and restraining me, pulling me from the edge. I did my best to try and calm down and we carried around the walk and then went home, myself occupied by the black thoughts, occasionally bursting into tears for no real reason. I spent a lot of time wishing I’d been quicker at the edge.

Sunday was miserable too. I’d taken the higher dose again, unsure if it was the Nitrazepam or something else that had caused the dramatic swing downwards. I was less out of control but just low and lethargic. The headache was even worse than the previous day. At puppy school I couldn’t stand up for the pain and had to leave my bloke to do most of the training.

I reduced the dose on Sunday night to 15mg. Halfway between my last dose and my new dose. I slept much worse again, but woke up with a clearer head. I emailed Dr G’s secretary with a message for her, explaining what had happened on Saturday and how I’d felt. I said I didn’t know if it was the Nitrazepam or just a natural swing, but that I would continue to take the reduced dose unless she suggested otherwise. She agreed to that.

I haven’t been sleeping well. I do not see much point me being on sleeping tablets when I still take ages to get to sleep, wake up in the middle of the night for a few hours and struggle with frequent waking and disturbing dreams. 10mg of Nitrazepam is meant to be the highest dose and should cause me to sleep for hours and still feel drowsy the next day. It just doesn’t. Even the 20mg dose didn’t have much of an effect on my sleep.

I don’t seem to respond to sedatives much at all. Zopiclone didn’t do much and makes me hallucinate and for that reason I haven’t been given Zolpidem. Promethezine Hydrochloride, Promazine, Diazepam, Nitrazepam all have had little effect. Quetiapine didn’t sedate me at all, even on 500mg. Depakote did have some effect, but generally just slowed me down all day rather than making me sleep. Only Haloperidol has successfully resulted in sleep, but even that included frequent waking and the subsequent hangover and drowsiness lasted all day.

I wonder if Dr G will find anything else to try. She goes through her psychotropic drugs handbook regularly under insomnia and never really finds a new solution. Melatonin was mentioned and may be the next attempt, but we shall see. She also suggested Temazepam but then prescribed Nitrazepam instead. Something I think she may be regretting. It all could have been very nasty indeed on Saturday if I wasn’t kept safe.

Also on Monday, my CMHT social worker came to visit. I hadn’t seen her for two weeks as she had been on holiday. We talked about what had happened on Saturday and I explained I’d contact Dr G about it. She didn’t seem too bothered. We spent the rest of the appointment talking about things that I spend my time doing. She seemed keen to get me to go to the cinema or swimming and spent far too long labouring the point. I know I have to try and find pleasurable activities, but when you find no pleasure in anything it is difficult. I remember her trying to explain a cycle of depression and how the way to break the cycle is to change our behaviour using CBT methods, but she didn’t have a clue about how the CBT model worked or much else for that matter. It turned into me explaining The Priory CBT model to her as she attempted to patronise and bluff her way through it. She kept saying how she’s only a lay person and doesn’t know much about psychiatry. I found this alarming when she is meant to be my first point of call on all things mental health. Why oh why do I not have a CPN? I keep wondering if it is too early to ask for someone else? I don’t like her, find her patronising and her lack of knowledge scary.

She was also meant to be reviewing what services to refer me to, but had forgotten and didn’t have any of the information. Surely I should be referred to these services asap as I’ll be waiting long enough as it is?! She said she’d put some info about other services in the post for me to look at so we can discuss next time, but I still haven’t got anything. She also asked if I’d got an appointment with the consultant yet, but I still haven’t. She was meant to have chased that up but hadn’t done.  No appointment and no information. The other thing she was meant to have done was refer me to some telephone support service that I can’t remember the name of. They were meant to call me when she had, but she clearly hasn’t done that either. Chocolate teapot comes to mind. A different one to Kate and Chouette’s though! Thankfully I don’t see her again for another three weeks.

Since Monday I’ve just been feeling generally low. Tuesday night was jovial, as we had our Ladies Circle meeting. I am always cheery when there, but it is only holding the mood back for a couple of hours, assisted in my act by alcohol. I suspect people find it hard to equate how I come across there, with the openly manic depressive person most of them know me to be. I’ve been open with the group about my mental health as they all know I’m on long-term sick. They probably wonder what, if anything is really wrong with me, but I can’t help the front. It’s second nature when with people I don’t know very well.

This morning I was left on my own for a short while whilst my partner went to do a couple hours work for his old company. Thoughts were running rife, but I kept them at bay. I am low, but managing to stay safe. I am just frustrated that I still don’t want to be managing. I know I should stay safe, but my thinking is still distorted enough not to want to. I have the insight to know this, yet still don’t want to and don’t know how to change it. It’s a trap I am caught in and I know it has to change, but when and how, I don’t know.

Anyway, I’ve rambled long enough. I hope everyone out there is okay. The madosphere is quiet, but then I guess it is summer. People are on holiday.

I see others are moving on or posting less. Paranoia about anonymity seems rife. I think it’s a shame, but understand why. I hope people can continue to blog safely elsewhere or are happy outside of the blogging world.

I’ve actually considered giving up on anonymity here recently. I’ve even mentioned my first name on one of my posts, although hidden. If anyone that knew me found this blog they would instantly recognise it as me. I think it’s important more people are open about mental illness and I have been trying to be a lot more open elsewhere, but here I am hiding behind a pseudonym. Maybe it is time for that to change. We will see anyway. I still worry about my future, employment and reputation and don’t want my moaning here to jeopardise that.

As an aside – what a lot of tags I’ve stuck on this post! Blimey!

More Evidence…

with 3 comments

Some of you may remember my post on Trichotillomania which I made a couple of weeks ago. In it I referred to this BBC article which mentions some research into the use of N-acetylcysteine (NAC) for the treatment of Trich. Today I saw Dr G and towards the end of the appointment my bloke mentioned the article and I explained it to her. I couldn’t remember the name of the drug involved, so she asked me to check and let her know. She hadn’t heard the news story herself, but was interested to know more and was happy to check if it will interact with any of my other drugs before I can give it a go. Dr G is quite progressive and innovative with what she prescribes anyway. She won’t always wait for things to become proven and approved before she prescribes something. She also mentioned a new drug, for which I could spot a leaflet about on her desk, that is meant to be good for sleep, but it’s also an antidepressant and she’s scared of the effect this may have being bipolar and my past experience of antidepressants. She said research is currently being done, but this one she didn’t want to risk.

Anyway, whilst I was looking up the name of the drug concerned in this article, I did a little bit of research and stumbled over the fact it had also been connected to improving residual depression in bipolar. Someone has done a some research into this and the paper was published last September. This article sums up the findings. If this really is the case, then there are two reasons for me to be taking it. I am certainly willing to give it a go. It’s a proven drug for other things, so should be safe and even if it isn’t, do I really care? Maybe that is flippant of me and my partner will be horrified to read it, but I really don’t worry about such things anymore. I guess that is the suicidal thinking that undermines everything. I should be thinking about this positively though and my willingness to try anything is the part of me that just wants to get better and doesn’t care how I do it.

For a change, Dr G was running on time. My therapist, M however wasn’t. With that in mind, we got started and did a quick meds review initially. The expected increase in Lamotrigine happened and an increase in the Nitrazepam too. I could do this prescribing lark myself these days! In two weeks time we shall do the increase again and I will then be on the 200mg she’s aiming for.

We talked about how things over the past few weeks seem to be showing signs of stabilisation and improvement. This is true but I say it with caution. In the past three weeks I’ve gone from rapid cycling every day or two between an almost okay mood and a horrifically suicidal one. This was followed by a week of consistant suicidal depression and generally feeling awful. Then over the last couple of days I’ve kinda felt depressed but getting closer to okay mood. The suicidal thoughts are still there, they never go away, but things are quieter.

The thing is, I don’t trust the cycles to not come back. My mood sometimes settles down and then the swings come back with avengence and I am up and down like a yo-yo again.  I also don’t trust the curve on the mood graph to continue rising. It has only been a couple of days of slightly improved mood and I’ve had that before. The bubble bursts as quickly as it forms.

Dr G is hoping that things are stabilising. Last week was stable but hell. If things stick like that it just isn’t going to work. I will get frustrated and then fall off a cliff, which is similar to what happened last January/February. She knows this and I think is as worried about it as I am, but I guess neither of us knows what to do about it. We just have to try and hope that this mood holds out.

M turned up and we talked a bit about what we’d said last week. Dr G was meant to have another appointment with the four of us there last week; Her, M, my bloke and me. At least that’s what three of us thought. Dr G was at her daughter’s graduation and had somehow double booked herself. The three of us carried on and had a session anyway talking about some of the relationship issues we’ve been having and communication. It is a topic that always comes up but an issue that doesn’t go away. Again the solution seemed to be to wait a few months and try not to think about it. Easier said, but they aren’t living with the torment all the time.

The rest of the appointment consisted of lots of ums and ahs whilst I grappled for something I felt comfortable to talk about. I generally failed until the mention of that article came up.

The previous couple of days have been spent at my grandparents. I hadn’t seen them since March last year, when it was my great grandma’s funeral. It was good I guess to see them although always a bit surreal and slow. It always feels like a bit of an act at the best of times, but even more so at the moment. I also saw my two cousins on that side of the family. H, the youngest, loved our puppy. My animal-mad aunt did too for that matter.

The future holds very little at the moment. I don’t know what to do with myself and that is scary. I have a lot of uncertainties and I want answers. I see my worker on Monday and Dr G in a couple of weeks. Aside from that, who knows?

A Bumpy Road…

with 4 comments

An awful cliche, but it sums things up. Not only am I still all bumpy with this damn rash, but I am still struggling.

I don’t really know how I feel because I’m up and down and numb all at once. Right now, my head is fuzzy and I keep feeling very dizzy. It means I can’t really think.

I am now getting moments where I feel okay. Better than okay even. I am thinking about what I could be doing and wondering if I can get on with life. The problem is, ten minutes or two hours later, I am feeling as bad as ever again. I am suicidal and see no future at all. I am trying to control the impulses, but I find myself not wanting to. This constant swinging is frustrating as each mood undermines the other and I find myself wondering what is the point if I am going to keep having these swings. It’s just a reminder of the grim reality of this condition. This has been a problem all weekend, but I found myself just pretending everything was okay, even during the bits that it wasn’t. Damn that automatic mask!

Ward round today and it seems my NHS support is not organised or forthcoming. This scares me as my health insurance funding is being stopped in 10 weeks as I’m now diagnosed with a long term condition. Damn my new diagnosis! Aside from that, ward round was productive and I feel a bit more prepared for tomorrow’s discharge.

A label…

with 4 comments

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

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

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

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

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

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

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

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

Slipping Back…

with 7 comments

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

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

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

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

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

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

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

Written by intothesystem

Tuesday, 6th January 2009 at 6:08 pm

Should I go…?

with 4 comments

I have an appointment to see my GP later. I don’t really know why I am going. I originally made the appointment to sort out medication, but then realised I needed to get the prescription last week before my All I Can Eat Certificate expired. I managed to get that sorted out by asking one of the other doctors to do the repeat and adjust my dosage (as requested by Dr G). This means the main impetus for seeing Dr. N is gone. I do need another sick note as I forgot to get one last time I saw him and my current one is out of date, but that’s not all that important. I don’t want to feel like I am wasting his time, yet I still want to see him. Considering I’d do anything to avoid doctors appointments in the past it’s funny that today I want to go and I don’t really have a reason to be there. Yes, I am actually ill, but there’s not much he can do. It’s probably as useful as going to the doctors with a cold. I feel like I am not worthy of his time.

I don’t really know what to say. I’ve been shaky over the past few days and up and down. I was very restless and agitated on Saturday morning. My partner battled with me to try and get me to sit still and calm down, but the more he tried, the more I found myself resisting. I was giggly and unable to stay still. I just wanted to be on the go and doing things. I didn’t want to stop, as my mind was racing. This was short-lived and by evening I felt very drained. I was very low in the evening and felt withdrawn. This mood continued on Sunday, although I was a little better by afternoon. We visited my relatives (Grandma and Aunts), which was weird, as they still do not know about my illness. White lies about work were necessary to keep up the illusion and I hate it. I know I should tell them, but I don’t know where to start. This side of the family are not known for their sympathy towards depression.

So, what do I say to my GP? I wonder if I should just cancel, but I find myself not wanting to. I want to see him, although I don’t know why. I wonder if he can just give me a bit of moral support. I think I need some encouragement to get me through the next few days. I’m tired and fed up of this endless depression. I am frustrated about treatment. I think I need someone sensible to convince me things will change, although I don’t know how much use he will be. I don’t know what to say to him. I don’t know where to start.

Hope or Hopeless?

leave a comment »

Reading back over my last post, I’m struck by the hopefulness of it. I didn’t think I felt especially hopeful when I was writing it, but that is the sense I feel looking back. At the time, I thought I was going through the motions, self-censoring my words to make it seem like I was hopeful. I had it in my mind that I would not return from London. I had it in my mind that I had to present that I was okay and going to be safe down there for my partner’s sake, but deep down knew I’d be battling against the safety measures that I had put in place.

As you can see, I have returned from London, so maybe my hopefulness was genuine? Maybe I realised that I would overcome my suicidal wishes and survive the weekend? I don’t know. My hope is as fleeting as my moods.

It was touch and go at times. On Sunday night, I genuinely thought I would not return. I had a clear plan in mind and was preparing myself for it. I was on the edge. I didn’t want to go home. I wanted to die. I got scared by my mind and the clarity of it and forced myself to take double sleepers to knock myself out. I think they worked. By morning, I woke feeling less certain of my plan and keen to get home. I felt mildly optimistic and even, dare I say it, happy?

How can one’s perspective on things change so quickly? I don’t know if I am coming or going. I don’t know if I am full of hope or hopeless.

My weekend, overall, was good. My mood was unstable, as is the usual, but I did enjoy Saturday night. Lots of alcohol and lots of dancing and I was okay. Moments of withdrawal and sadness descended if I stopped to breathe, but I kept them at bay with a relentless performance of “coping”. I tried to live in the moment, something we are continually preached about at The Priory. It was enough to keep me going and even enough to let me smile a little and actually believe in it and mean it.

Sunday was a slow one and much harder. I didn’t have an alcohol hangover, but a mood one was definitely apparent. We didn’t do much. Stayed in the flat most of the day and went for food in the evening. There was no pressure and with that, I could manage. I had to battle against the thoughts in my head, but without any need for a performance, I could concentrate on that and concentrate on the moment. It was okay.

Last week I didn’t see past the weekend. I didn’t expect to see today. A friend of mine said to me on Friday, life is like driving in the dark. You can only see as far as your headlights allow you, but you know that if you keep going you will see a little further and if you keep going like that you can go all the way. I think that is how I’m living life at the moment. I can’t see very far. I don’t really want to see very far, but I am still getting through each little bit. I just hope that my headlamps don’t go out any time soon or the fog doesn’t get any worse. I’m still struggling and I hate it.

My mood dropped again yesterday. I was at The Priory and although Art was reasonably relaxing, Support was uncomfortable. I was agitated, unable to stay still and the conversation was irrelevant to me for most of the session. I sat and tried to listen, but all I could think about was my unrealised plans from the weekend. When it was eventually my turn to speak, I unleashed my frustration at my mood. My frustration at the speed in which it twists and turns. I did not know what else to say and neither did anyone else. Their depression is explained by divorce, family issues or work stress. Mine is explained by nothing. By faulty brain chemicals or a disordered personality? I do not know and I still don’t have any answers. I am fed up of it.

I don’t know what else to say anymore. On Sunday, I had lost all hope. On Monday, it returned. Yesterday, it was wavering. Today, I do not know.

Past Lives…

with one comment

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?

Frustration…

with 5 comments

So since I’ve returned to blogging I haven’t actually had that much time to write about how I’m actually feeling at the moment. I’ve caught up on the past, but not looked at the present, let alone the future.

I’m currently frustrated and agitated. This has basically been the case on and off all week and I’m not sure how I feel about it really. It feels like I’m on edge and it could go either way. I could either become more and more hyper or I will drop off a cliff fairly soon. Neither option particularly appeals, as I suspect any hypomania would be of the dysphoric form. The experience that is a mixed mood is one I am frequently familiar with these days, but not one I enjoy that much. As Seaneen describes it, it’s a particular form of hell. Alternatively, the falling off a cliff is not much fun either and I’d rather not go there if I can!

I saw Dr G yesterday. This is the primary cause of my current frustration. I wrote to her, as I’ve felt that I’ve not been getting anywhere lately trying to talk. I asked about diagnosis again, but she was fairly evasive. She talked about how I had various issues, primarily that of a mood disorder, but there were other things at play. She mentioned the question over a personality disorder diagnosis and was quite vague about this. She said that although personality disorders are one of her specialties (especially Borderline PD) she is reluctant to apply the label of a personality disorder on anyone for various reasons. Mainly she said that it is such a misunderstood label and can often be bandied around to avoid giving treatment. I don’t know if that means she does think it could be applied to me or not. I couldn’t really tell from what she said and I suspect she is still not sure.

I also tried to discuss the best treatment options for me going forward. I explained that I didn’t feel I was making much progress, if any, and that I was frustrated by this. She seemed to think I was making progress, but that it was going to be slow. In terms of therapy, she didn’t think there was much else that we could do. She seemed confident that it will help me to manage my condition and will make a positive difference. So far I’ve not been so convinced. I want it to work and I want it to help, but I just don’t know if it is. In some cases I’ve been using many of the techniques for years to manage my condition, but I’ve just not been able to keep it up over the past few months. These skills just aren’t working anymore and it makes me feel like a failure for not feeling the benefit. CBT frustrates me, because as much as I try to counteract the negative thoughts with evidence, rational thinking and the rest, it doesn’t work. There is still this inner commentary counteracting everything I do, telling me it is all pointless and that I am wrong. I don’t know how to stop it. I sometimes wonder if I am just too ill for therapy at the moment. A lot of the time I just feel like I cannot engage and make the most of it. I don’t know when or how that is going to change.

She also went over my meds. She wanted to put up the Venlafaxine, but decided it was probably not a good idea due to agitation I had been experiencing. She’s going to review in about ten days, but said she may put it up then if I’m not feeling much improvement. We also moved all the quetiapine to a night dose, so I’m now on 225mg Venlafaxine in the morning and 350mg quetiapine at night. I am not sure how I feel about the quetiapine. I suspect without it I’d be sky high or unbearably agitated, yet I hate the numbing feeling it leaves me with a lot of the time. I just feel fuzzy, foggy and empty a lot of the time, but maybe that’s not the quetiapine at all. Maybe that is just how I am at the moment. I don’t know.

I left her office feeling extremely frustrated and even more agitated. I didn’t know what to say. I just felt like I wasn’t getting anywhere. She is still avoiding the question of diagnosis and is still telling me to be patient and keep trying. This was not the answers I was looking for. I had gone in there with my notes, hoping that I’d get some answers to my questions, but the reality is I left with the same questions I entered with and a feeling that she isn’t really listening. I don’t know if that is really the case, or if she is just powerless to help. She doesn’t think there’s much else we can do at the moment. She tells me there are no guarantees, but she hopes that I will get there slowly with the right medication, right therapy and enough will power and patience to stick at it. I don’t know how I am going to find the will. I just feel that I am battling and battling and not getting anywhere. Every step forward is followed by two steps back. I didn’t really know how to tell her I am so close to giving up. I cannot handle the waiting and uncertainty much longer. I can’t handle feeling like this much longer. I don’t really see where I am going with this and don’t see any way out. It feels like I’m never going to get anywhere, I’m never going to get better, I’m never going to understand this illness, I’m never going to be able to really talk to people, I’m never going to just be happy and content, I’m never going to win against the negative thoughts, I’m never going to want to live, let alone know how to handle it. I know that sounds awfully defeatist and pessimistic, but I’m being driven that way by illness, frustration and constant disappointment. I just don’t know what else I can do.

Today I saw Dr N, my GP. As always it was nice to see him, but it’s more of the same really. He was concerned by the agitation, but was convinced the venlafaxine is to blame. He didn’t really know what to say. He said he felt pretty impotent at the moment and it’s true. There’s nothing he can do whilst Dr G is managing my medication. He suggested it might be worth adjusting my meds, but we have to wait and see what Dr G says. He just tried to be encouraging, telling me to try and distract myself and channel the agitation and to just stick with it. I don’t really know what to say to him anymore. He just tells me week after week that there’s no easy solution, but hopefully we’ll get there eventually. I feel like I’m letting him down by not getting better. I feel that I’m letting everyone down.

I think I’m on the edge. The edge of this mood, the edge of reason, the edge of life? I don’t know. I just don’t know what to do anymore and don’t see where this is all leading.