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Posts Tagged ‘paranoia

Home Alone…

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Time keeps passing. I don’t know where it goes to.

This weekend has been somewhat strange. The bloke is away for the weekend at a stag do and I’m home with just the doggy for company. I don’t remember the last time I was here on my own overnight, let alone for a whole weekend, so I don’t really know what to do with myself. Aside from my trip in the summer, there have been so few times when I’ve been without the bloke for more than a day since we went to uni. I was “well” in the summer too and now things are not so easy. I am managing, but it has made me realise how used I am to having him around and how much his presence keeps me functioning. Without him here, the temptation to give in and give up is so much greater.

Getting up and dressed is a struggle at the moment and I feel even less urge to conform when I don’t have reminders from the bloke. The guilt wears on me when he’s about and it serves to push me into action. It was only the desperate requests from the dog to be let out, that dragged me out of bed this morning. The thought of having to clean up any mess was enough to force me downstairs, but I climbed back in when she was sorted. I had to get up in the end as I was going over to a new friend’s for her kiddy’s 1st birthday party, but it took me literally hours to work myself up to that. Without that commitment today, the temptation would have been to stay in bed all weekend.

Food is another problem. The bloke is the cook in our house. I can bake cakes, but when it comes to a proper meal I don’t tend to bother. I don’t have the best appetite these days, but when food is presented to me I do tend to eat. Without the bloke around to cook for me, I don’t tend to bother. I’m even less inclined to cook at the moment as both our oven and the microwave are broken.

The dog is a commitment too and she does keep me going, but she isn’t as effective at nagging as the bloke is and I find the commitment straining. She did get me up this morning and she gets me into the kitchen, prompting me to eat at the same time that I feed her, but she is also tiring and I feel guilty when I just want to stay in bed and ignore her. She also got me to go outside for a walk, which I know is good for me, but at the same time I wish I didn’t have to. It’s so tempting not to bother, but I cannot deny her a walk for long or she turns into a great big bonkers thing, which is even more draining to live with than the walk.

I’m really tired. I want to sleep forever, yet sleeping for just a few hours seems to be enough of a challenge. It was late when I finally dragged myself upstairs to bed last night and I sat and knitted up there for a while because I couldn’t sleep.

Before the bloke left, I had to promise I’d be safe this weekend. He has been somewhat paranoid over the past few weeks that I’m suicidal again. The last two years have been particularly difficult at this time, in the run up to my birthday, so I know he is on edge. He doesn’t trust me at all and although I know his fears are not unfounded and it is only because he cares, it is still hard. One day last week I had nipped out and wasn’t home when he was due back from work. My mobile phone battery had died so he couldn’t get hold of me. I’d even left a note to say that I’d be back in a minute, because I worried that without my phone he would wonder where the hell I was, but he didn’t see it and just flew into a tailspin instead. He completely jumped to conclusions and panicked that I’d gone out to kill myself.

I’d actually nipped out to rescue the dog’s ball because she had lost it on our walk and I couldn’t get it out of the brambles and control her at the same time. She has a habit of diving head first into all the brambles and rose briers to rescue her ball then getting stuck – we both end up cut and bleeding, as I have to battle to rescue both her and the ball. I literally had to drag her home, shut her in the house and then go back out to dig out the ball from the bushes. By the time I got home I was greeted by the bloke just about to drive off in my car to try and find me, ranting and raving with anger. This isn’t the first time this has happened, but it the first time in a long while and I was disappointed that things had not moved on and that the trust hasn’t been rebuilt by now.

It turns out that he mainly panicked because he had been reading my mood log. I was updating one online and I had no idea he had been reading it. I tended to keep my notes in there very short and they were only for me, so a note mentioning suicidal planning thoughts did not necessarily mean what he thought it did. I was angry that he had invaded my privacy again, but I know it only comes from fear and concern. I don’t feel able to update the log any more though. It was meant to be for me and no one else. A reminder of how things are, because so often I cannot remember what my mood was like a week or a month ago.

But anyway. I agreed that I will be safe. I am safe, but it doesn’t mean the temptation isn’t there. My mood is low and I’d be lying if I said I didn’t think about it. This weekend would have been the perfect opportunity and there are times when I cannot help the thoughts, but I have resigned myself to sticking around for a while yet.

I know the fact it is winter and in the run up to my birthday can’t be helping. I have been in hospital at this time for the last two years, and both times I was desperately suicidal and determined not to be around for my birthday. This year I seem to have accepted that I will be around and although I am not overly happy about it, I’m resigned to it. I am low and I don’t really want to be alive, but I feel the obligation to be. Also, I’m not sure why, but being 25 seems like a much better idea than 24 anyway – something about round numbers I think. My worry is that I’m already having to battle the thoughts that 25 is a good age to die. I have no desire to see 26, even if I am sure I will see 25. I hope that my mood will pick up before those thoughts get too strong or that the approach of my 26th birthday gets too urgent.

As for my 25th birthday, as Seaneen will recall, my invite for a smear test arrived. I went and had it a couple weeks ago and it was fairly painless and straightforward, although I bled quite a bit afterwards. Unfortunately though I got a letter on Thursday saying the result was “inconclusive” so I have to go and have another one in three months. I think this was just a case of not enough cells, at least that’s what I’m hoping, but it’s still pretty annoying to have to wait before they do it again.

In other news, I’ve had a review form for DLA to fill in for a couple of weeks now and I’ve failed to do it. I wrote to them before Christmas at the same time I wrote to notify the DWP that I was starting work part-time for ESA purposes, to say there had been *some* improvement to my condition since my initial application for DLA. I felt I had to, as I have been receiving Higher Rate Care and I am not sure I should be getting that rate any more. They sent me out a review form and I started to complete it, but I made a complete mess. I filled in my surname in the first name section, my date of birth wrong and made mistakes all over the place, because I couldn’t concentrate enough to fill it in and my memory is so shoddy I kept forgetting things. After some frustration, I rang them to ask for another form because I had made so many mistakes. I got this replacement two weeks ago now and I have still not even started it. Thankfully because I requested the review rather than them, there is no deadline for me to get it back, but I know I need to do it. I can’t face it though. I can copy across the stuff that was correct on my first attempt, but I don’t know what to do about the rest of it. The form is overwhelming and I don’t know what to write, especially as my mood has been so unstable of late. Sometimes I look at the form, think nothing is wrong and answer everything as if I was fine, but other days I look at the form and realise I can’t do any of the things it asks, including filling in the form for that matter. I know you have to say how your good and bad days very and highlight what the worst case scenario is, but I just don’t know what to write. I don’t even know what to put in the diagnosis section. Should I have told them that my diagnosis is under question back when it was first questioned a year ago, or can I just tell them I don’t know any more? I guess the latter is the truth, I don’t know, but I’m not sure if I should have told them I don’t know. As far as DLA and ESA are concerned, I assume they think my diagnosis to be Bipolar II disorder, which is what it was when I applied. As I don’t know what it has been changed to, I guess I can’t tell them, but I worry about what Dr M or Dr N will write when asked. I hate having to evaluate how bad I am. I honestly don’t know.

Hmm I don’t know what else to write. There are things I keep thinking about to write, but I just don’t know what to say. It has been the same all week. For weeks really. I am meant to be keeping a diary for therapy again and I haven’t managed to write anything properly. I just don’t know what to say. Brain is mush. I cannot think, I can barely feel. I just want a new head.

I am feeling increasingly agitated this evening. I am not sure why. Maybe now is the time I stop and knit for a bit to see if it calms me down. I spent a lot of yesterday knitting – I made a hat for the little boy’s birthday today and started a frilly scarf and it kept me busy and distracted whilst I was on my own. It’s the first thing I’ve done for a while. I haven’t had the motivation or the concentration for a while. Sometimes I get the urge to knit and think of a million projects I could be doing and other days I cannot even comprehend lifting the needles. There has been a lot of the latter lately, yet yesterday my head was buzzing with ideas of things I could knit. I can only knit so much though and when my concentration is so crap lately as much as I want to make these magical creations, there’s no way I’m actually able to. I end up having to undo as much as I do.

hmm. Head is starting to spin. I’m both tired and agitated and feel like I may need to throw things soon if things get any worse. I don’t know why I am feeling like this. I have been good lately and I’m avoiding caffeine in the hope that would ease the occasional agitation, but it doesn’t seem to be helping. Maybe I should just go to bed and try to sleep or maybe I should have a bath. Perhaps I’m just grouchy and tired. I don’t know.

This is a bitty post. I don’t seem able to write properly at the moment. I started writing this about 4pm and it’s now 11.30pm. It’s not even very long. I have found it really hard to try and get things down or to concentrate on it. I have watched bits of TV and fed the animals and stuff in between, but the rest of the time I have just been staring at the box wondering what to put in it, or more likely how to slow down and speed up and unravel my thoughts to try and type them. Some of the time it feels like my brain is like treacle and the thoughts are just so slow and other times they are bouncing around and rattling off the sides and at the moment both is happening at the same time and it just feels like a big ball of mush. It all makes no sense.

Anyway I am going to stop and kick the dog outside. She’s already taken herself to bed, but she needs to go out or I’ll get woken up very early in the morning! I don’t intend on being up early. The bloke isn’t due back until at least mid-afternoon and I think I’m leaning towards a morning of hibernation.

I feel crap…

with 23 comments

I’ve got a much longer post in the making about returning to work and all that jazz, but right now I just need to whine. The other post doesn’t portray much of how I’m really feeling. It is about recovery, yet at the moment that seems like a strange concept.

I feel crap. Not just a little crap, but really crap.

I’ve been trying to avoid admitting this, but pretending things are okay never does me much good. Maybe if I’m more honest and accepting of how I feel, it will help to ease the pressure a little? I am trying so hard to keep functioning that I am probably making myself worse. I don’t know, but I need to do something and I hope that writing about it will help for a moment.

My mood has dropped. Not just a little bit, but a lot. I could feel depression creeping up on me again, but this past 10 days or so have been far, far worse. During the past week, I have felt worse than at any other point in the last six months. My mood slumped at the end of September /early October, but it didn’t slump this far or this fast. Things had picked up quite nicely since then (and the increase in Reboxetine) and I thought it was just a temporary blip, but now I feel awful and I’m less sure it will be temporary this time.

Every morning is a real struggle at the moment. It is hard for anyone at this time of year, waking up when it is dark and cold outside, but this is more than just winter blues. When I wake up from yet another night of broken sleep and nightmares, I feel the familiar cloud hanging over me. It is a cliché, but it is definitely there, dark and cold, looming over the bed. I realise that it’s back. Depression is here and I am hit with a daily dose of disappointment that I haven’t woken up feeling any better. The sense of dread about yet another day hits me and I want to hide under the cover and never come out.

I know I need to keep functioning and I am forcing myself to keep going, but it is getting harder. On some days I have to go to work and there is plenty for me to do the rest of the time, so I have no choice but to keep going. I force myself out of bed, but it is getting later and later and the incentive to do so is diminishing. I was making myself get out of bed by 9am at the latest, no matter how badly I’d slept the night before, but I can’t do that now. Most mornings I am forcing myself up at 10am, but it was later than that yesterday. If it carries on like this, before long it will be lunchtime before I usually get up. I am doing my best to stop that happening.

I feel guilty when I am like this. I chastise myself for being lazy, but I don’t want to be. I just can’t find the motivation to not be. I know the bloke would chastise me too and that makes me feel more guilty and makes me want to hide how I am feeling. It is nearly always the motivation that goes first. Motivation is tied to noradrenaline and that is what the Reboxetine is meant to be working on, but it doesn’t seem to be doing enough at the moment. I need to get it back, but even forcing myself to do things isn’t likely to help much. It will just tire me out and make me frustrated when I can’t seem to cope.

I am still going to work. I refuse to admit defeat on that. I can’t give up on work. I don’t want to let people down and I don’t want to admit that I can’t cope. I’m worried that everyone will blame this relapse on work and say that I can’t do it. Maybe work is to blame, but I don’t see how it can be. It is not stressful and I was enjoying it at first. It felt really good to be going back and I had definitely missed it. I was being careful not to push myself too hard. My four hours a week were going really quickly, but as my mood has dropped, time has slowed down to a crawl and my last few shifts have felt excruciatingly long, despite being so very short. I have been struggling to find the motivation to go as well and have arrived late a few times because I had been putting off getting ready. My concentration appears to be slipping and I have to keep stopping to remind myself of what I was meant to be doing. I had run out of work the other day as well, so it felt like a complete waste of time and boredom was not helping my mood, but I have now got something new to do, which made it a little easier today.  I will manage though. I have to.

I am struggling to do much else at the moment though. Fighting depression and carrying on with work is sapping all my energy. There is housework to be done, but I am trying to get by with the bare minimum. I sit and stare at the laptop, but I don’t do much with it. I am barely bothering to read blogs or even the news at the moment. I spend too much time hitting refresh on facebook or hotukdeals, because they require little attention. I leave emails unanswered or unsent because I can’t concentrate long enough to write them properly. I am trying to knit a hat for my sister’s Christmas present, but it is slow progress and I keep making mistakes, despite switching to an easier pattern. I tried to go Christmas shopping on Monday, but I was so indecisive I barely bought anything and it took the whole day instead of the few hours I had planned. I have voluntary stuff to do – website updates and press releases to write, but I am putting it off.

I did manage to cope with fundraising at the Christmas Fair on Saturday though, which was a relief. I had been dreading it because I didn’t know how I was going to cope. Adrenaline helped get me through the day, which was a long one to say the least, but I survived. I was working with a decent bunch of girls for most of the day, so at least I had some support and there were plenty of yummy cakes to cheer me up, but I was flagging by the end of the day. We raised a decent amount of cash, which I guess makes it worth it. I felt completely frazzled afterwards though. I had to go out for the bloke’s work do in the evening, but I was exhausted and didn’t really want to go. I did and it was a nice enough evening, but I think I’m still recovering from the late night and long day. Everyone else was drunk too and I was driving, so that didn’t help me enjoy it. My head was so fuzzy, I have no idea how we got home safely. Not good really.

I curiously did the PHQ-9 and the BDI the other day, because I saw reference to the PHQ-9 somewhere and I suspected my scores would show I was depressed again. Scores of around 20 and 30 respectively puts me right on the Moderate-Severe threshold on both scales. I don’t believe that it has got that bad so quickly and I think severe is pushing it, but moderate depression is probably a fair assessment at the moment. Strangely, my scores are worse in different areas to where they used to be, but it’s still higher than I had expected. My BDI score did get up to the late 50s/early 60s though when I was really unwell, so there is a long way to go before I get like that. I did a retrospective scoring for how I was during the summer, just to compare and I would have said my PHQ-9 was about 4 or 5 (not depressed/mild depression) and my BDI around 8 (mild depression?). Things have definitely gone down hill. I think my “natural” state is probably a little on the low side anyway, but this is more than that.

Physically I feel awful as well. Tummy troubles continue. I spent one afternoon last week rolling around in agony. The pain in my gut was just so bad and it came on so suddenly I didn’t know what to do. It was probably the worst attack that I have had and it took a few hours to settle down to a dull ache. My appetite was hit by it and still hasn’t really recovered. My bowels just can’t seem to find any sort of rhythm or pattern, no matter what laxatives or diet I am eating – eat eggs and I end up with diarrhoea, eat beans and I can end up constipated. It makes no sense at all.

In general, my body feels really run down. I have a cold sore and have had a few spots break out lately. I think I may have a urinary infection of some form. I’ve spent most of this week constantly needing to wee, although thankfully it hasn’t felt burny/stingy, so I’m not sure. Last night, a lymph node at the back of my head (behind my right ear, up from my neck) has swelled up and it is really painful. It feels like someone has hammered something into the back of my head and that they are constantly notching up the pressure. I couldn’t sleep at all with it last night. I had the same thing happen on the other side a while back and it took a few days to go down. I hope it does soon. I am not sure how much longer I can take this.

I went and saw Dr N this evening. I was hoping he could at least suggest something to fix my body, if not my mind. Sadly he didn’t have much to offer either. That may be partly because I didn’t know what to say to him. I didn’t tell him all that I wanted or meant to. I seem to have forgotten how to talk about this stuff and I keep forgetting things I should do or say.

He asked me what had triggered my mood. I said I didn’t know. Possibly the time of year, but I’m not really sure. He asked what support I was getting from the CMHT. Nothing is the answer I gave and the truthful one too. I had a phone call last week to tell me they’ve “closed” my case, because I no longer have a worker. They had forgotten to sign off my old CPA when my social worker C left, which was back in June, but someone had found it and said they would send it off to me so they could close my case. Dr N had received a copy too, remembering that there was an apology attached to the front. I don’t know what he thought about that. He asked what other support I have. I reminded him that I am still seeing Dr M as an outpatient, but I won’t see her until January now. He asked about the psychology referral. I’ve not heard anything. He sighed at that.

He mentioned that her last letter suggested that I drop the Reboxetine a few days a week to see if that helps the side effects. She suggested either going every other day – 6mg one day and 8mg the next or even 8mg in the week when I have to work or am at home alone and 6mg at weekends when I have more support. Dr N said he thought the latter may be worth a try, because he hopes that improving how I feel physically may ease my mental symptoms too. He doesn’t think 6 or 8mg will make that much difference either way to my mood, but it might help with the tummy troubles. I am not so sure about the idea, especially in light of my dropping mood. In fact, I’d even tried a few days on a slightly higher dose – 10mg (an extra half tablet), just to see if that could kick my mood back up quickly. No such luck though. I guess it is worth a try.

I didn’t know what else to say to him and in the end we just wished each other a good Christmas and I left. I walked out and finally started crying. I’ve needed to for days, but the tears hadn’t come. I don’t know what to do to stop this decline and I don’t feel like I have anyone to help me. I am scared about Christmas and January and all the memories that this time of year is dragging up. This time last year I was telling myself I just have to get through Christmas. I am doing the same now. The problem is, last time I got through Christmas, only to try and kill myself when January came. I don’t want that to happen again. I am not as bad as I was back then. Things have moved on a lot in the past year. I have hope that my mood can recover again, where as last year I had no hope at all, but I am starting to feel more and more helpless and I fear that I will always be waiting for the next relapse. I am terrified that every time I try to live a normal life, depression will come back and bite me. I don’t want that to happen. My mood has to pick up soon. I need to keep going.

This only seems to scratch at the surface of what I am thinking right now. I am scared. I am worried about what everyone will think. I don’t want to let everyone down. Everyone has been so pleased about the progress I had been making and seemed to be excited about me getting better. I had been so pleased too. I thought I was getting my life back. I am going back to work at last. I am driving again. Everything seemed to be getting back to normal. Things seemed to be going really well. Then I am hit with this slump in mood and I don’t know what to do with myself. I know recovery is a difficult process and I’m always going to have set backs, but this feels different. It isn’t just a bad day or two. Nasty thoughts are creeping back in. I am having to put on my happy face. Life feels like a struggle, rather than just being life. I hope it is just a blip. I really do.

I’m also scared about the diagnosis stuff being stirred up. I was recovering, medication was helping, my condition wasn’t pervasive and untreatable, so I couldn’t have had a Personality Disorder. If I’m getting ill again then people will probably start thinking that it was just a co-incidence and that I do have a PD after all. Maybe I am being paranoid, but I am scared about this. I was glad that I had responded to medication. I may have been treatment resistant, but at least I was treatable.  Now I just feel like a failure. It will be back to the theory that I need therapy if I am ever to recover and I will be blamed for not recovering. No doubt I will never get offered therapy anyway, even if I need it, but I was hoping I didn’t need it. I don’t know. I don’t want to think about it. Whenever I think about what went on earlier this year about my diagnosis I get panicky, anxious and upset. It seems to hit a nerve and I have to stop thinking about it.

I hate feeling like this. We will see how things go. At least I have admitted it now. I have been carrying around these thoughts like a guilty burden. I have been secretly acknowledging the depression, whilst denying it in the hope it would go away and that no one else would find out. I feel like I am letting everyone down. I wanted to have a “happy ever after” for this blog and then I’m back here again whining about depression again. That isn’t what I wanted. Sorry.

A Little Clarification…

with 8 comments

My last post, Distressing Diagnosis… was a little on the rushed side and basically unfinished when I posted it. I knew if I didn’t publish it when I did, I wouldn’t get the chance for a while, but I kinda wish I’d held back. I’ve been back and edited it a little, but it still doesn’t say everything.

Edit: (17/03/2010) – I’ve actually ended up reworking this post quite a lot too. I didn’t read it back yesterday and since then I’ve realised it was all over the place and made little sense. It is a little better, but I just find this so hard to write about objectively. I am struggling with it all.

Lets get one thing straight. Dr M isn’t a horrible person or a bully. In many ways she’s actually quite nice and well meaning. She is trying hard to help. I can see that and I appreciate it.

She said she doesn’t want to do anything that will make me worse, and she did agree to remove the diagnosis in my notes when I said it wasn’t helping. I guess I can’t really argue with that. I asked her to change her diagnosis and she agreed to do so. I don’t think she’s changed it in her mind, even if she has on paper, but that is at least something.

She genuinely thinks she is helping and that she is doing the right thing. She keeps saying that she will make me better and that the future is hopeful. She is always very positive and encouraging. Many patients probably really appreciate this approach, but I find it a little too much. I don’t see enough evidence to support her positivity and that can actually be damaging. It makes me lose faith and trust. I find that she can ignore the negative, which means I don’t feel like I am being listened to or taken seriously. Unfortunately she doesn’t seem able to recognise this or she is unwilling to adjust her approach.

She also gives me her time – lots of it. She tries not to rush her appointments and lets them take as long as they need to, even if that means she runs behind fairly often. One of my ward rounds was over 90 minutes long, which when I realised seems pretty incredible. She saw me regularly on the ward in addition to the weekly ward rounds. She is now seeing me fortnightly as an outpatient, as opposed to the huge expanses of time between each CMHT appointment (4 months!). This is a good thing. It is closer to what I was used to in The Priory and a vast improvement on my other NHS experiences. Usually they sit you down and before you know it the appointment is over and nothing seems to have happened.

There are certainly good points to her care so far. I think it probably is an improvement on my other experiences with the NHS, but there are issues and I am finding those hard to deal with. Overall though I don’t think she’s a bad psychiatrist. I am just not sure she is the right doctor for me and I am not sure I am the right patient for her. Things just don’t seem to be working.

I don’t think it helps that we just don’t seem to get on. She was not impressed with my initial request to not be patronised and I think that clouded her opinion of me right from the start. She doesn’t seem to understand my job and why I like it. She doesn’t seem to know how to deal with me questioning her. I have a real sense that she just doesn’t like me for some reason. There was one point that she pretty much said that she couldn’t get on with me in “real life”, although I can’t remember the context now. My bloke tells me that is paranoia, but I remember it because I was shocked at the lack of professionalism and was upset that she didn’t like me.

I know I can’t hold this against her though. People don’t get on with each other and that’s a fact of life. If she doesn’t like me then fair enough. I’m not sure I’d get on with her in “real life” either. It wouldn’t matter though if it didn’t affect our therapeutic relationship. I worry that part of the reason she has diagnosed NPD purely stems from a sense that she doesn’t like me. Is it because she thinks I’m arrogant because I didn’t want to be patronised? Is it because I don’t agree with her opinion? I fear that in many ways it probably is.

It’s always going to be easier to trust and work with someone you get on with and I am finding this hard. It was one of the things I found great about working with Dr G. We got on well and could talk about anything, not just my treatment. It felt a lot more therapeutic and less clinical, which I think is important when dealing with mental illness, which is so entwined with emotion. I miss the way things were with Dr G and I am not used to the change. I don’t see the relationship with Dr M ever being like that. I find it hard to talk to her and hard to trust her. I am meant to tell her how I feel, yet I don’t feel comfortable doing so.

I also struggle with the fact that she doesn’t seem used to dealing with patients who are capable of getting dressed, eating and general functioning. Even if you had just tried to kill yourself, said you felt absolutely terrible and were threatening to do yourself in, if you could get up and about, communicate, eat and drink etc. then you are not really depressed and should be discharged. There seemed to be little acknowledgement of the fact that patients hide how they are feeling and put on a mask. There was a lot of focus on the functional side of depression and little acknowledgement of the emotional side and how patients felt. I wasn’t the only person who noticed this. A few of the more functioning patients felt that they were always being pushed to go home, treated as if they weren’t really ill and made to feel like they were a fraud. One patient was discharged too early a couple of times because she always hid how she felt and seemed “well” but she ended up back in hospital within days. You would have thought they would realise this was a problem. I don’t think this is purely down to Dr M. There were unbelievable bed pressures and the nurses weren’t exactly great at observation, but at the end of the day she makes the decision to discharge.

I wondered if this was because she is used to treating patients who aren’t functioning – those who are catatonic, staying in bed, barely speaking etc. In many ways these patients probably are more severely depressed, but that doesn’t mean they are more “worthy” of being in hospital. Non-functioning patients are a lower risk because they aren’t even capable of hurting themselves, where as a functional patient who is dealing with distressing thoughts needs to be kept safe. There didn’t seem to be much acknowledgement of this. I always felt like I was being told my problems weren’t important and that it didn’t matter how I felt.

Maybe Dr M has a problem working with me and other patients in a similar situation because she just finds it easier to deal with patients that do as they are told and don’t answer back. I guess anyone would find it easier to deal with people that follow blindly and don’t question things, but it is wrong to judge those that aren’t like that. Maybe it is as simple as a power trip. She likes to be in control and feels threatened when that power balance is upset? I don’t know.

It was also a common complaint on the ward that she thinks she’s really in touch and that she knows what you are thinking, but the reality is she’s often a long way off. Sometimes you get this hint that she might actually understand and then she says something else to contradict that five minutes later. It can be quite frustrating because you get this feeling of hope that she is listening and understands and then you get disappointed. You often feel like she is jumping to conclusions or judging you and I find it hard to talk to her. I don’t have this problem with Dr N and I never had it with Dr G. They listen to you and seem to understand what you are trying to say.

I think my feelings towards the NPD diagnosis have made it hard for me to work with her. I am offended and upset by it and I associate her with this distress. It feels like a personal attack and I find that hard to deal with. I don’t want to be considered as narcissistic, arrogant, self-serving etc. I want to be a “nice” person, someone that people can trust and get on with. I read the descriptions of people with NPD and I am scared that anyone could think I was like that. I am disgusted with myself that someone can think I am the horrible person that the NPD diagnosis describes. I can’t handle my thoughts and emotions around this and I need someone to direct those frustrations at. I guess naturally I will direct them at her. As much as her views of me may be misguided, my feelings towards her are skewed because of my feelings around this.

I still don’t think the NPD diagnosis is very accurate (although I do understand to some degree why she may have diagnosed it). I certainly don’t think I meet the criteria and I think she was wrong to diagnose it in the way she did. I really question her judgement and it is going to be hard to work with that in mind.

Personality disorders seem to be her diagnosis of choice and that worries me. She seems to be giving anyone that doesn’t respond well to medication, functions “too” well or who doesn’t fit in the usual boxes, a personality disorder. There was someone on the ward who was diagnosed with Bipolar Disorder many years ago and she had seen multiple psychiatrists who agreed with that diagnosis. Dr M began treating her, quickly questioning depression and suggesting her personality was to blame for her thoughts. There seemed to be no logical reason for this, only the fact that she functioned fairly well and medication had stopped working.

I guess in many ways a PD diagnosis means the emphasis is on the patient to get better and not the doctor. If the patient doesn’t improve the psychiatrist doesn’t need to justify herself in any way. The patient is also fairly powerless because any questioning of the diagnosis could be considered a symptom of the disorder. “I’m the doctor, you’re the mental, now do as you’re told”. It probably helps that there is enough of an overlap between symptoms of a personality disorder, general life experience and other conditions that there will probably always be some evidence you can use to back up your opinion.

A little off topic perhaps, but I do still want a second opinion on the diagnosis, but I don’t know how I go about getting it. With the diagnosis lifted from my notes, I don’t know where I stand. My personality is now “under investigation”, but does that mean she is going to change the way she thinks about me? I doubt it. Do I just wait and see what happens when the therapy referral comes through or do I try and get things clarified now? Presumably there are still mentions of the narcissism on my notes, so will that influence things in future?

I wonder if I should ask about the Affective Disorders clinic in Manchester. A couple of people have suggested it to me and they have someone who focusses on “complex needs”, who may be able to comment more on the relationship between my mood disorder and any personality problems. There’s also the CUPS service in Cardiff, who has a similar service offering second opinions to anyone in the UK with complex mental health issues. The problem with these services is they require referrals from your consultant and I don’t know how to ask her, without sounding like I don’t trust her opinion.

I don’t know.

I still don’t really know what to do or think about it all. In some ways I know I should just try and forget about it now that the problem label has been rewritten, but the therapeutic relationship thing is a problem. I still have to see her every couple of weeks after all and I don’t know how things are going to work.

I guess my conclusion is though that Dr M isn’t all that evil. It’s the NPD diagnosis that’s the problem and it is going to be an elephant in the room for a while I think.

ESA Medical…

with 9 comments

I know I’m updating a lot all of a sudden, but I guess there are things I want to document this week. My talkative mood is probably helping too.

I made it to my medical this afternoon. I am so glad it is over.

I was all over the place during the interview. The doctor kept asking the same things over and over again and it was tiresome. My head was spinning, thoughts racing, agitation brewing. I kept forgetting what I had just said and found myself getting more and more worked up. I couldn’t keep still from the agitation. It didn’t help that she wasn’t following things, but I don’t know if that was me talking too fast or her being a bit slow. She kept mixing my doctors up (I know it’s complicated. I still have 2 psychiatrists!) which was getting really confusing.

She didn’t seem to ask me much about what I can and can’t do. She did ask if I got up, dressed etc (yes, with bullying from my bloke). She asked me if I went anywhere (yes, if someone takes me – I mentioned Creative Remedies). She asked me if I saw friends and socialised (sometimes). She asked about driving (no, not since October 2008).

We talked a little about my overdose in February and what happened afterwards. We talked about ECT. I told her when I’d been in hospital. We talked about my current care – The Priory and transfer to NHS, who does what. She asked me a million times if my doctors knew what I was telling her and who was most up to date with everything. I didn’t know why she was asking that so much. Maybe so she knows whether to trust any information she gets from them or so she could check up on what I was saying?

She kept asking me about suicidal thoughts. She wanted to know why I hadn’t tried again if I still experience the thoughts. She asked me literally 30 times if I had any active plans, maybe even more. She seemed quite concerned when I was honest about the extent of my thoughts, even though I have no real means or firm intention to act at the moment.

I was forced to talk about anger and violence. I couldn’t deny that it has been a problem of late, but I didn’t want to be seen as “dangerous”. I felt so uncomfortable talking about it.

We talked about mood. I found it hard to convey what it is really like. I told her about the current agitation and how this is a fairly new development. She suggested the agitation could have been caused by anxiety about the appointment. I didn’t think it was and denied it at the time, but since I’ve thought about it some more I think it may well have contributed. I really was all over the place whilst I was in there and anxiety must have been exacerbating the situation. I tried to describe the aching, dull, flat, numbing depression that has lingered on and off for ages. I tried to describe the mixed agitated depression that is often a problem. I don’t think I succeeded on any account.

I mentioned that my partner had given up his job to care for me and she asked me about this. Is he with me all the time? How often does he leave me on my own? Who does what in the house? Do I ever go out on my own? etc. etc.

When we went over my meds, she seemed surprised that I am taking melatonin and even asked if it’s a hospital-only prescription. Considering melatonin can be bought over the counter in the US, it does make you wonder why it is so reluctantly used over here. The CMHT seemed surprised too.

At one point towards the end, she left the office to go ask her colleague something and I couldn’t help but burst into tears. I’d been holding myself together up until then, but the stress of it all tipped me over the edge. I don’t know what it was as I barely ever cry these days. Girlie hormones probably aren’t helping at the moment, but even still it seemed ludicrous. Unfortunately she came back in whilst I was trying to pull myself together and then asked me a million questions about why I was crying. I was worried she would think I was putting it on for effect or something. I genuinely couldn’t help it, but was so embarrassed and paranoid about it.

Although she asked me a million questions I don’t know if she has got anywhere near enough information. Most of the stuff didn’t seem to be very relevant to whether or not I can work. Maybe she was just nosy? I guess that’s her job.

I cannot convey how erratic the whole appointment was. Questions were being fired in all directions and I was so mixed up I couldn’t answer her. My sentences were blurring into one. I was jabbering on and on and going off on tangents. I didn’t say half the things I should have. I was not clear at all. I’ve been going over things in my head since, trying to make sense of it all. Trying to work out her intentions and what she was thinking and asking. I know I should just forget about it and wait for the results, but my head is just looking for things to think about.

One thing I have noted is the clear effect of stress. I was anxious and stressed by the situation and I could not deal with it at all. I was turned into a whirlwind of agitated confusion. I’m just thinking about work and similar situations where I have to answer questions and think about what I’m saying. Conference calls for example. There is no way I can handle one at the moment. It’s okay doing that with a doctor that is trained to deal with it, but it is not okay to talk like a madwoman in front of your boss.

In some ways my inability to deal with the situation may stand in my favour. I suspect now I probably came across quite mad. After all, I need her to think I am too ill to work. The problem is, I think I may have come across *too* mad. I was incapable of answering her questions and I’m worried I may have messed up in some way. I’m worried I didn’t answer things clearly enough or that I missed things out. I am paranoid that she was trying to catch me out. I’m really worried she will think I was putting it on or making things up. I wasn’t, but I wasn’t “myself” either and that could be problematic.

Afterwards I was tired and didn’t really want to do anything. The session took it out of me and I needed processing time. Kinda like therapy actually. I guess it was similar in that I had to talk a lot about how I was feeling and what has happened.

Unfortunately I wasn’t really given that processing time as my bloke wanted me to do stuff. He forced me to clean my car, which took ages at it was filthy. As I’m not driving at the moment my lovely little car spends most of its time sat on the drive. It has been sat still so long that green slime was growing on all the window seals. Not good. It’s looking better now, but there are still bits that aren’t quite there.

My thoughts are still racing. I walked the dog this evening and I thought that would help calm me down but it hasn’t. I was distracted thinking about the medical, work, suicide, random pointless stuff, everything. I have music spinning around in my head on top of everything else. The “We buy any car” advert is driving me mad… we buy any car, we buy any car, any, any, any, any, we buy any car… Make it stop, please!!

I suspect I won’t be updating quite so much in the next few days. Nothing is happening. We are taking the dog to a breed show on Sunday, but that is all I can think of. I will see Dr N sometime at the end of next week. I have Creative Remedies too, but nothing unusual or exciting coming up.

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!

reading back…

with 3 comments

My post yesterday is rubbish. I was rushing it because I was stressed and it shows. I don’t think I could convey how frustrated I was feeling though and it’s written now. It might as well stay.

My mood was fractured yesterday evening. The nothingness had dissipated and was replaced by this agitated blackness. I was struggling to concentrate and just wanted to escape and be alone. I spent the night thinking about suicide and looking for alternatives, feeling more and more certain I don’t have any other options. It’s still on my mind, but I keep pushing it away. I find myself wishing that living was a viable option, but it just doesn’t feel like it at the moment. Death doesn’t seem all that viable either though. I’m scared I’ll fail and have to deal with the consequences of a failed attempt. That doesn’t fill me with much hope or encouragement. I think about running away. Leaving this life and starting a new one somewhere else, but I know that is all fantasy. I wonder if it is possible to just leave and never come back.

My partner would ask what was up last night and I’d just put on my happy face and pretend things were okay. He could see I was agitated – the fact I was grizzly like a toddler was a bit of a give-away. I couldn’t hide it, but I couldn’t explain either.

I didn’t eat my dinner. A few mouthfuls of curry were all that I could manage. Cold curry leftovers for lunch today, but not sure I can even face it now. It’s good curry too. I’m just not hungry. My bloke made a silly joke about not cutting myself when preparing the squash and it just made me want to more. At least I think he was joking. I don’t tend to cut though as it’s too hard to hide. I also had this feeling of not wanting to give him the satisfaction of knowing he was right saying that, although I don’t know why he’d be satisfied.

Went to bed and tried to sleep but my mind was going over and over reasons to live and reasons to die. I eventually fell asleep before I’d reached a conclusion.

This morning I feel less wound up, but still a little bleak. I feel lonely and unwanted. I have been trying to talk to people on msn, but no one is responding. Paranoia kicks in and I don’t know if it’s because my msn isn’t working or because they don’t want to talk to me. No one at work is responding. I wonder if they’ve got fed up of me asking what’s going on without me there. I feel left behind. I know I am meant to be taking a break, but it’s weird to know someone new started yesterday to take on my old role. I hope she does it justice, although I wonder how she is going to learn everything without anyone to teach her. I’m jealous, which is silly, but I can’t help it. I worry that people will talk about me and compare me to her, making comments such as “at least she [the new girl] isn’t mad” or something.

Seeing my friend from work on Monday was good, but difficult at times. It was nice to see her and we chatted a lot. I didn’t know her all that well, but she asked questions and wasn’t scared of my responses. It was good to talk about things in an open way . I guess because I don’t know her all that well, it was easier to be open and honest, especially as I knew she was interested and comfortable with what I had to say. I found myself wanting to open up more, but knowing if I did it would probably step over the mark. I talked about frustrations at work and found it difficult to be honest, knowing she sits next to my line manager at my old desk three days a week. I’d worry something I’d said would let slip. It was late by the time I left though and I found myself not wanting to go home. It was good to escape for a bit and just have some time to focus on myself and how I’ve been feeling. I felt bad that we talked about me for most of the night, but she didn’t seem to mind.

I’m seeing another friend tomorrow I think. Haven’t seen him for a while, but he’s a friend I’ve shared things with in the past and one that understands what it is like to feel like this, so it should be good to catch up. I miss him.

I’m going to see Ben Folds this evening. I love Ben Folds, but hope he is less disappointing than he was at Glastonbury. It will be nice to immerse myself in some music for a few hours though.

Today has been another day of nothing so far. It’s what I want, but I still feel guilty for it. I am not good at doing nothing, but I think that’s because so often I’m berated for it. My mother forever moaned at me for procrastinating and my partner seems to now too. I wish doing nothing was okay, but even I get frustrated at myself for endless procrastination. I still have a list of things I have to do and another list of things I want to do, but I can’t find a way to work through them. I try to set myself little targets, but then get upset when I fail. Today I must swim, but I’m going before the gig as it is on the way. Until then, I imagine I’ll just waste the rest of my day.

Written by intothesystem

Wednesday, 9th July 2008 at 1:11 pm