Into the system…

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Posts Tagged ‘openness

Phased Return…

with 29 comments

So last week, I finally met up with the HR manager to discuss Dr Occy Health’s latest report and we have agreed that I can begin a very slow phased return.

I am starting with 2 hours a week on Tuesdays and Thursdays. I will be doing this for the next few weeks until I see Dr Occy Health again in December, when we will review again. All being well we will add a few more hours to each day and eventually extra days until I am back full-time, but I have been told to expect this process to take many months. I have no idea if I will be able to cope with going back at all, but it is time to try. It has to be a case of seeing how it goes and hoping that the transition is smooth.

It’s more than two weeks since I saw Dr Occy Health and our discussion about how I may go about a return to work. He seemed reluctant to try and push me into anything more than I was already doing (the occasional short visit), but I asked about formalising something more and he agreed I could begin with a slow phased return. He set some guidelines, but said I would need to arrange the details with HR, rather than him prescribe anything more definite.

The guidelines suggested that I am restricted to a maximum of 15% of normal hours at first. I didn’t ask him if he meant contractual hours or realistic ones, but I suspect he meant the former. It would mean quite a big difference – my contractual working week was 37.5 hours, but realistically I did anything upwards of 50 hours. I don’t think I will be allowed to do those sort of hours again though. Essentially I am restricted to a maximum of 5 and a half hours, which I guess seems reasonable, although of course I am only doing 4 at first. I don’t know how long this restriction is meant to last – the first week, first fortnight, first month? It looks like it will be at least the first month though and possibly even until the new year.

He suggested I start my working day during late morning, which suits me fine. I am usually at my most stable in the middle of the day and I am not used to early starts any more, so it makes sense for me to try and work when my mood is best. It also gives me the chance to take the dog out and get anything else that needs to be done beforehand.

Whereas over the summer my mood was consistently on the low end of normal and hardly ever changed, since the slow decline in my mood during late September and the subsequent increase in Reboxetine, my mood has been fluctuating a lot more. I am having good days and bad days, rather than lots of okayish ones and my mood is varying during the day too. Over the past month, my mood has been largely following the classic depressive cycle of feeling worst in the morning and mood improving throughout the day. I am waking up feeling pretty depressed each morning, but by lunchtime I am usually feeling okay. By evening, I am often feeling agitated or edgy, which is also not conducive to work either, so not leaving work until too late in the day is probably wise. Occasionally I’ve had a day that has gone the other way around or the morning depression has lingered long past lunchtime, some days are just crap all round, other days are absolutely fine. On the whole, I think the increase in Reboxetine has brought my average mood up again, but I am less comfortable with the instability that has come with it. I don’t know how I am going to feel from one day to the next and I find it harder to plan what I’m going to do, because one day I will be able to get loads done and the next I can’t face getting up. My mood isn’t really getting to the extremes, but it’s wobbly enough to be problematic.

Alongside the fluctuating mood, is also a fluctuating, but omnipresent level of anxiety. Most of the time I don’t even know what I’m anxious about, but I just feel the physical presence of anxiety lurking in my chest and a niggling worry about something in my brain. Sometimes that physical presence is a lot more than just a niggle and I feel physically sick, my heart keeps skipping a bit and I feel dizzy and shaky. I am getting a lot of nightmares too. Often I don’t know why this is happening. Sometimes the cause makes itself very clear and I can’t stop thinking about it no matter how much I try. There are plenty of worries about work, how it affects my benefits and finances, my tummy troubles, medication, diagnosis stuff and other stupid things like “what am I going to knit next?” floating around, but they shouldn’t be enough to prompt the level of panic I’ve been experiencing.

I don’t really know where this anxiety is all coming from, because until fairly recently I’ve not had much of a problem with it. I am usually pretty good at managing my worries and very rarely have I experienced the physical symptoms of them. Anxiety was always tagged alongside my list of diagnoses and I was often sent to “Anxiety Management” at The Priory, but I think that mainly came out of an assumption that all depression comes with anxiety and not because I actually experienced it. I can use those anxiety management skills and rationalise my worries and thoughts, but I don’t seem to be able to beat away the physical results. I have been taking Propranolol for months and that is supposedly meant to reduce agitation and anxiety, but I don’t know if it does much good. Reboxetine is known to increase anxiety, so it could just be that, but I am loathe to attribute everything to the damn drug.

Anyway, we shall see how I go with my working hours. I think if I stick to the middle of the day I will be okay. I don’t think there is anything stopping me going in a bit earlier or later if I want so if needs be I can do that, but I think it’s important I try and stick to a routine and get used to going to work at a specific time. I don’t know what will happen when I need to increase my hours or which end of the day it would be better to add to, but we will come to that when it happens. Having a routine and going in at regular times is one of the things I am going to need to adjust to. I’m not sure I’m up to doing stuff whenever I have to, rather than just when I feel up to it. When I’ve had chores I really need to do and am having a bad day it can make things a whole lot worse, so I hope I can manage.

Another guideline suggested that whatever I do is non-client facing. This is pretty important to me at the moment, because I can’t deal with the stress and responsibility that goes with working directly for the client. I am having to remember how to communicate in the world of business and not the world of mental health services or just with my friends. I think it is going to take some getting used to. I don’t know what to write in work-related emails or how to talk to people any more, so I’d rather keep my communication with others down to a minimum until I get used to it. At least if I make an idiot of myself with a colleague it’s not going to get me fired, but say or do something stupid with a client and I could be in trouble.

This is actually something that upset me during the HR meeting. The HR manager said she was worried about how I am going to cope interacting with others in the workplace. She remarked that observing me at the community meeting I went to the other week, she was worried that I was too honest and open with people and she is worried that my openness will shock people. She said she doesn’t want me to stand out too much or give people the wrong impression. I don’t think I said anything other than that I’d been off work for a couple of years due to illness, but I am currently in the process of returning to work. I didn’t elaborate on what kind of illness I’d experienced. I only said that because we were asked when we joined the company and what client we were working with at the start of the meeting. If I didn’t explain that I’d been off for a while, it would look like I’d been passed over for promotion a couple of times and that I wasn’t chargeable to a project, which I think would have been more embarrassing.

I’m not ashamed of the fact I’ve been ill and don’t see why I should hide it from people. I didn’t mention mental illness, but even if I did, it shouldn’t be a problem. I’m sure nobody would be telling me not to tell people that I’d been off work if it had been cancer or a heart attack keeping me away, so why do I have to hide it because I’ve been off for mental illness? I don’t intend on telling everyone the whys and wherefores, but questions are going to be asked or assumptions made unless I say something. You can’t just ignore two years of my career that have just disappeared. The gap in my company CV and in my client history is plain for everyone to see and the fact I’m still at my current level over 3 years after joining, also points to some kind of problem. I don’t see what is wrong about being honest about the fact I’ve been on long-term sick leave. I don’t know what else I’m meant to say. I have no intentions of lying or deliberately hiding the truth.

She said I should treat it like starting a new job and I should remember that I will be meeting new people all the time and they don’t know my history, so I should feel no reason to tell them. I understand this and agree, but the problem is that there will be plenty of times that my absence will be obvious. My company start date and level is on my people profile and my CV is on the system for anyone to see. The question of what client I am working on or have worked on in the past is going to come up. People I have worked with in the past will see me and ask where I’ve been. People will see me arriving and leaving the office at strange times, only working for a few hours and doing pointless tasks. I can’t hide things forever and I see no reason why I should, especially as I don’t have to worry about HR finding out, resulting in me losing my job. HR know the whole grizzly story, so there is no reason to hide. I will have to be honest with whoever I work with next, because I will be working reduced hours.

I was really quite upset by this comment and it took a lot to bite back the tears that were threatening. I knew I couldn’t break down at that point, because she would never think me well enough if that happened. I really would look like an overly emotional mental person if I burst into tears in her office and it would confirm all of her worst fears, so I did my best to maintain my composure. She thinks that I’m not able to act professionally and deal with people’s reactions and of course her comments do feed my own fears and anxiety. I am scared about what I will say, but I have thought about it a lot and see no option but to be honest. If they aren’t happy with that, then it is their problem, not mine. I know I am going to have to get used to this kind of thing, but it hit a nerve. I worry I will be faced with this dilemma for the rest of my life.

I’d asked Dr Occy Health if he thought I should or could go to the all-day community event and Christmas party in London. I’d like to go because I have missed out on the last couple of years and the meetings are usually interesting. I think it would be a good opportunity to find out what is happening in the company at the moment and the party should be fun too! I was a bit worried about the fact I will be travelling down to London on my own and it may be a bit much, but I think I will be okay. Dr Occy Health agreed that it would probably be good for me and said he would put a comment supporting my attendance on his report.

HR Manager was less keen on the idea. She was worried about me travelling to London on my own and is worried that I won’t cope with meeting everyone. She seemed worried about how it will look if I manage to attend a whole day event and a party, yet I’m only able to work four hours a week normally. People may judge me for it. They may, but it is a bit different spending a day listening to someone else talk than actually having to do proper work and very few of them will know I’m working reduced hours anyway. We have agreed to take a call on it next week, so we shall see what she says. I don’t know what is the right decision, but I’d like to go if I can.

I can’t remember what the other guidelines said. I think they probably mentioned local working and having a local manager, but I’m not sure. There was a note about me being protected by the DDA and the fact that these could be considered “reasonable adjustments”. Finally it was noted that I should be reviewed by Dr Occy Health in early December.

I hope I can manage. I have survived my visits so far, but I think it will get harder when I have to tackle some proper work. I have run out of initial tasks now, but HR Manager talked about the possibility of me doing some work for her. There’s a project she is considering that is related to something I did on a previous role, so I may be able to help with that, but I don’t know yet. I’m just waiting to see what she suggests.

At the moment it is a bit frustrating. I feel weird when I arrive at work so late and have to leave so early. I worry what everyone thinks of me. I generally feel okay whilst I am working, but I struggle either side of it. Strangely, one of the weirdest things is wearing smart clothes again. I am not used to it.

I wish I could fast forward to being back properly, but sadly that is not an option. I have been off work for nearly two and a half years though and I know it is going to take a lot of adjusting to go back. Dr Occy Health keeps reminding me of this and I think as far as he’s concerned, it’s a miracle that I’m trying to go back at all. This is somewhat disheartening, but I know the statistics and he must see enough people that never make it. I hope I can be one of the lucky few.

Anyway, I must stop writing now. I always finish blog posts like this, but I never get the chance to say everything that I am thinking at once. I have been writing this on and off for days anyway, so it’s time I posted.

Written by intothesystem

Tuesday, 16th November 2010 at 6:35 pm

Stream of Conciousness…

with 10 comments

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Mind Spinning…

with 3 comments

I have so many potential blog posts spinning around my head. So much I want to get out of here. I keep seeing things I want to comment on and I just don’t seem to have the time or the means to articulate the things I want to.

I don’t really know where to start and I don’t really have time to start. I wish I did.

By the time I get around to writing what I want to, no doubt the moment will have passed. I wanted to comment on the Kerrie Wooltorton case. I wanted to comment on The Conservative party’s proposals to “Get Britain Working”. I don’t know when I will find the time.

There are personal things I wish to say too. I am unsure I can say them here. I feel torn between the need to share and the need to hide. I feel torn between honesty and not wanting to worry people.

There is one other debate I’m having at the moment with myself. The question of anonymity. I have written about this before, but it’s all about the balance of being honest and open about my illness and wanting to hide things and protect my family from the worst of it all.

If you know much about me you could probably find my blog. For example, a search for “Creative Remedies” puts me in the top 5 results on Google. Knowing just a few basic facts you would identify me from reading here. I guess this just makes me wonder if I should be done with it and stick my name on here.

Anyway the short window of time I had to write has come to an end. I’ll be back soon.

Written by intothesystem

Saturday, 10th October 2009 at 2:12 pm

Trichotillomania…

with 8 comments

This is interesting. I have pulled my hair for so long I can’t remember not doing it. It’s something I’ve always been ashamed of, but don’t seem able to stop. My partner can never understand why I do it even when he tells me not to. It is something that gets worse when I’m stressed or feeling low, but is such an ingrained habit it is there when I’m well too. I really do wonder if there is a magic pill that could stop me and if so, why haven’t I been given it yet?

Aside from that, today I saw Dr G with my bloke and therapist. It was strange having the four of us in Dr G’s little room. I felt quite intimidated and overwhelmed and it didn’t take me long to start crying from the stress of it all. We talked about how I need to be more open about things, something that has been repeatedly a topic for discussion, but something I find very difficult. I often think I don’t want to be open and honest about how I feel. I don’t want people to panic and I don’t want to be helped. If you’re feeling really suicidal, the last thing you want is everyone to know so they can stop you. I don’t see how I can break that barrier to openness.

Yesterday I finally met my CMHT worker, J. She’s a social worker, not a CPN, which I’m slightly disappointed about. I have been told they don’t distinguish between them in our trust, but I somehow think a CPN would be more use. They’d have more understanding of my illness and what it really entails. We chatted about my life and the past year as she wants to get to know me. I don’t know if what I said was helpful but the time raced by. I wanted to ask what is going to happen to me but she didn’t seem to know. She was surprised that I hadn’t yet had been sent an appointment with the consultant so is going to chase that up. I am not sure her coming to see me is going to be that helpful but we will see. I might be able to talk to her properly eventually. I found I was being economical with the truth when she asked me how I was feeling. I couldn’t help it. I don’t yet trust her. I see her again next week.

I am seeing Dr G again on Thursday as she didn’t have time to do a medication review today. She said she’d review my sleep again, which has gone haywire since coming off the Haloperidol. I’m a little more awake during the day but not sleeping much at night. Temazepam was suggested so we shall see what she comes up with. I’m sure the Lamotrigine will go up again too. She has to titrate it up so very slowly. It’s hard being patient waiting for the increases. I just want her to stick it up to a high dose and be done with it, but I know she can’t.

Generally I feel a little empty and numb. I am just carrying on because I have no choice, but it’s hard. I don’t want to.