Into the system…

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Posts Tagged ‘phased return

Too much to say…

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

On my own…

with 7 comments

My care-coordinator, C came to see me on Thursday. We weren’t meant to be seeing each other until Monday when I had my appointment with my psychiatrist, Dr M, but C called me on Wednesday to tell me she wanted to go through the updates to my CPA and risk assessment beforehand. When she arrived she told me the real reason she had came was to tell me she is leaving. It was nice that she wanted to do this personally and made the effort to make the appointment to see me before she went, but I’m sad that she’s going. She’s been asked to work in a CAMHS role, which is what she trained in. I think this is really positive for her and she seems excited about it, so I’m happy for her. I’d just got used to having her around and she was so much nicer and more helpful than useless SW, J, who I had before, so it is a shame. It was quite nice to know she was there if I needed her as I had faith in her, but I think I’ll be okay anyway.

I was asked what I wanted to happen now. I had the option of being assigned someone new or having no one assigned and letting Dr M and my GP, Dr N manage things for a while. I decided to go for the latter. I’ve never found the CMHT overly helpful and I am not sure I really need a social worker at the moment, although it was nice to have C there, just in case. To be honest, I think not asking for another person is more about trying to avoid another useless SW like J was. She did more harm than good I think. I’m not quite sure about the prospect of being a little on my own, but I think it will be okay. I’ve been told I can ask for one at any point and someone will be assigned, so this seems to make sense. I think whilst I’m just waiting to see if things stabilise there isn’t that much to do or say. It just seems to be a case of waiting to see if the improvements hold out. I do wonder if it will be helpful to have someone involved when I am trying to return to work, but we shall see what happens.

Saturday was a bad day. I guess one had to come along again at some point, but it was worse than I’d expected. I woke up feeling a little dodgy in a physical sense, but after a silly argument with the bloke things went downhill. I was crying almost non-stop for hours and when I wasn’t crying I only felt capable of staring into space. I couldn’t think and felt completely exhausted. It got to the stage where I couldn’t really speak properly and when we went to Morrisons I was struggling to do much more than walk around like a zombie, whilst my bloke did the shopping. Something just wasn’t right. I felt depressed, but I didn’t even have the energy to be suicidal. I was just devoid of anything. In the end I couldn’t wait to get to bed so I could start a new day and hope it would be better.

I felt a little better by Sunday morning and by the evening I felt okay again, so hopefully that has passed and won’t happen again. I don’t know if something just snapped or if crying wore me out, but it wasn’t good. I just felt so awful and it was horrible to be back in that place. I’ve not experienced that sort of catatonic depression much as I have a tendency to irritability and agitation, but it is scary when it happens. I don’t know how anyone gets through days or weeks or months of that. I guess the fact is, you’re so down it is impossible to do anything but wait. You don’t have the energy to end it.

On Monday I saw Dr M again. It was a bit of a nothing appointment really. We discussed how the last 6 weeks have gone, but there wasn’t much to be said. Things are still much the same as when I last saw her. I am a lot, lot better, but not 100%. Still getting the odd bad day that catches me off guard, but most of the times things are in the realms of normal. We talked about possibly increasing the Reboxetine again, but she was inclined to leave things as they are for now. She wants the option to manoeuvre the dose up again in future if things dip over time or if  I struggle whenever my therapy referral ever comes around. If she puts it up now, she wouldn’t really be able to increase it much more without pushing the side effects up into unmanageable territory. She asked if I’d heard anything about therapy, which I still haven’t. It’s getting a bit ridiculous because it gets pushed back further and further, but it doesn’t surprise me at all.

We talked about the fact I was seeing occupational health today and what I felt about it. She asked me when I next wanted to see her, which I felt was positive. I was given the option of two weeks, two months, whenever or never again. This would never happen with the CMHT, although I’m not sure how serious she was about never again! I suspect she may have had something to say about it if I chose that option. We decided I’d call her when I have decided though, based upon what was said at occy health and whatnot. She was good to point out I can call her whenever if I need to see her between appointments. I’ve been pleasantly surprised at how things have changed between me and Dr M. I didn’t like her at first and I really got the feeling she didn’t like me, but now she’s seen improvements and got to know me a little better and not the me she met when I was in hospital, things have improved. We shall see how things go. I don’t know what happens when I am passed back to the CMHT or discharged by her, but at the moment I’m appreciating the stability and glad I’m not being passed from SHO to SHO.

So today was occupational health. I have been worried about this one because the nice consultant I’ve seen in the past has left the firm. I have to confess to googling the new guy (another Dr G, so not sure I’ll be using that moniker for him) and I found out he has worked for the Health & Safety Executive in the past and has a more safety-focussed history than the last doctor – I got the impression ladders and chemicals were more his thing than mental health, but I could see he was an experienced occy health consultant, so he was going to have come across psychiatric patients at some point in his career. He seemed nice enough. Quite softly spoken and very keen to point out that he is not on anyone’s side and that he has my best interests and health in mind, so I guess that’s good to know. I’ve found that to be true for all of the occupational doctors I’ve seen. Every time, they’ve been supportive and they are not just trying to get me back in work. A pleasant contrast to the DWP/Atos Origin lot I guess, who only seem to care about declaring you fit for work (although to be fair in my case they didn’t).

We discussed how things were compared to last time I saw Dr R. In general, things have improved a little and the improvements have been maintained so that is good. He asked me how I felt about work and occupational health. I confessed to being in two minds – half the time itching to get back and on bad days, worrying that I’d never be well enough. He said that was to be expected, which I guess is true. I was pretty surprised that early on in the appointment he made it pretty clear he didn’t think I’d be returning any time soon. He feels it will be a long time before I go back properly and that I need to show stability for a while before we consider it. I was hoping to go back in some capacity soonish, so I’m disappointed really. I guess I have to slow down and wait and see how things go. I am aware that I shouldn’t rush things, but at the same time it’s about balance, because if I wait too long I will begin to feel useless and get frustrated.

He also said that a return will be very slow when it comes and it could be a very long time before I’m back at work properly. At first it will be just dropping into the office a couple of times to say hello and then maybe working an hour or two a week, building that up to a few mornings or afternoons and then we’ll see. I suspect I will get impatient with that approach, but I know it is what we have to do. I know though that I have a tendancy to do more than I’m meant to, so it will be difficult I think.

Now that I’ve been told I definitely can’t work yet, I feel a bit stuck. I’m having to wait and be patient and I am getting itchy. I had thought that I’d be going back sometime this summer. I expected to be setting a date to start a phased return, but I’m apparently not even ready to do that yet. I have to wait a couple of months before I see him again. If things have improved/stabilised then we can “possibly” start to plan a return. He did suggest three or four months before I next saw him, but I felt that seemed too far away. I’m worried I’d miss my window of opportunity to have some “normal” life. He agreed on two months or so unless I go downhill again in that time. He said I deserve to have a bit of happiness first, which I guess is a nice thought, although it also makes me worry he feels I won’t stay well if I do ever go back to work. I also wonder if I can be really happy if I’m not working. I want things to be normal. I want a career. I want to stay well.

In a way it is good. I know that I don’t have the worry of going back to destabilise things whilst I’m still not 100%. Maybe the therapy assessment will come through in time. It might be good to follow Dr R’s recommendation that I wait to see how I get on with therapy before I return to work. I don’t hold out much hope on that one though.

I guess this time of year is the best to be off too. Summertime. I won’t have to worry about taking time off for holidays. I can make the most of the sunshine, when it happens. I felt awful for most of last summer and I didn’t appreciate it. I am appreciating the sunnier days now.

I guess I can also stop feeling guilty and worrying about being on ESA and in the support group. When I have a good day and I feel normal, I wonder why I’m not at work. I am in the support group, which means I am meant to be too ill or disabled to ever consider seeking or returning to work. Until recently I thought that was the right decision, but as things have improved and I have got keen to return, I wasn’t sure I fitted that criteria any more. I always hated the thought that I was too ill to consider working, even though I knew it was true, but I find it even harder now I am not so sure. Before, I did fear I’d never go back. I couldn’t see any sign of improvement, but I hated the fact that others didn’t have much hope of improvement either. Now I can see that improvement I want to work. I loved my job and I miss it more than ever now. To be told I’m still not well enough to consider working is sad and hard to admit. The upside is though I should stop worrying they will accuse me of benefit fraud. I am not allowed to work even if I want to, so I have to accept that. Without the blessing of Occupational Health I can’t go back.

I just can’t shake off the feeling I am being held back, but at the same time I need to stop myself trying to run before I can walk. I’ve been off work for two years and during that time I’ve been very ill. I know that. 6 months ago I was in hospital. A few months ago I was still threatening to kill myself. Things have improved a lot in a short period of time, but unfortunately that doesn’t mean they can’t change back in a short period of time either. I hope they won’t. I don’t think they will, but it seems I have to prove that these improvements are going to hold out and I can reach some form of stability, before I can consider myself well.

Hmm. We shall see. We shall see.

p.s. I did a quick edit on this post on 9th June. I ran out of time yesterday so the last couple of paragraphs had been somewhat rushed and I didn’t say everything I wanted to. I also didn’t tag things properly. There is still more I can say on this, especially as I spoke to HR today, but I will leave that for another post.

Busy, Busy, Busy…

with 9 comments

For someone that doesn’t work I seem to be awfully busy at the moment.

And it seems I won’t be going back to work for a while.

My consultant had been pretty keen for me to contact my employer to try and look for a strategy that would see me getting back to work, or at least to get me back in contact with them a little more. It was suggested that perhaps I could help out with some corporate citizenship work or at least have a contact in the area I could meet up with to discuss work. All of my contact has been with the HR team who are based in London. As I am not allocated to a project I don’t have a manager at the moment, let alone one in the North West. I don’t even have a “Career Counsellor” right now as mine is on maternity leave. So I’ve had very little contact with work and I’ve only been into the office once in the last 18 months (to get my laptop upgraded). The place has become completely alien and the thought of trying to go back is pretty scary. I don’t think Dr M realistically thought I’d be ready to go back in the immediate future, but she wanted me to consider doing something to give me hope of going back.

So I contacted my HR rep to see what she thought. She needed to look into this and wanted me to go see Occupational Health before she made any decisions. She didn’t want to allocate a new Career Counsellor unless I was actually going back, so that wasn’t an option, but she did say she’d look at finding a Manchester contact for me. She wouldn’t agree to the idea of me going into the office or helping out unless there was an OH report which supported this. I suspect their liability insurance wouldn’t be too happy if I was on sick leave, went into the office and then I hurt myself or something.

So I was referred back to Occy Health. An appointment was arranged and I saw Dr R on the 18th. I’d seen him before, 18 months ago. He had been nice last time and had a lot of experience in psychiatry, so I was glad it was him again. He remembered me and I tried to update him on what had happened. I have a document saved on my computer which covers all the main events of my “Mental Health History”, so I took this with me to refer to. I think he was pretty shocked at what had happened since I’d last seen him. At the end of the appointment he said that when he saw me last he’d expected me to have a pretty rough time over the coming year or so, but he’d never expected it to be as bad as it was.

He mentioned a lot of the usual occupational health stuff. Things about how work is generally good for people and that I should be encouraged to go back as soon as possible. He quoted the statistic that 50% of people who are off work for more than 6 months never return (Scarily, 75% of people off for over a year and virtually none of those off for two years or more ever return) and he commented on how long I’d been off. He said he was concerned about my chances, but he was hopeful that at least I have youth on my side.

He seemed genuinely worried that I may be dismissed due to incapacity if I was off much longer. I am worried about this because my Permanent Health Insurance payments would cease if that happens. He said he’d hate to think I’d have a life of benefits ahead of me. Not exactly what someone needs when they are struggling to handle the thought of being alive. He warned that with such a long absence and dismissal for ill health, I would be nigh on unemployable, which is a pretty depressing thought. I should have a great career ahead of me and instead I am dealing with the possibility that is over. I hope not.

We discussed whether or not I could go back to work. I don’t really think I am ready. I’ve only been out of hospital for about a month. My medication is still being adjusted and I am struggling with side effects and anxiety. Things are so unpredictable that I just don’t know how I can plan to go back so soon. I was pretty surprised when Dr M brought up a return to work in the first place, but I understand that I do need to go back as soon as possible and was willing to at least see what could be done.

He agreed with me though. He wants me to be fairly stable for a couple of months before he considers approving a return. He seemed a little surprised that I had even been referred to him so soon after coming out of hospital. He was uncomfortable with pushing me back too soon because there is too much at stake.

If I went back to work for a little while and struggled, ending back on sick leave, then I would not only lose my ESA for 6 months, but I’d probably end up losing my job. They’d be more likely to dismiss me if I failed to complete a phased return. Of course there’s also the very real risk that it would tip me back over the edge and I’d try and kill myself. Not exactly something anyone would want to risk encouraging.

We also discussed the fact I am waiting for therapy and I’m likely to find that pretty hard going. It would not be good for me to go back and then to start therapy. There is good chance that it will make me worse, before it makes me better and we wouldn’t want that to risk my return to work. He’d rather that I knew at least what was happening with my therapy referral before I go back.

He did agree though that we should be doing something to normalise work and the office a bit more. I need to be in contact with HR and I need to go into the office occasionally before I try to go back. At the moment I feel like I don’t belong there and I hardly know anyone. It would be good if I could get used to going in before I try and do any work there. He agreed that helping out with the occasional task might also be helpful and a good way of keeping me in touch with work. The more we can do to convince my company that I do still want to work for them and that there is a good chance that I will again, the better.

So that’s the plan. Try and get more in touch with work, keep myself busy and doing enough work related tasks as possible and lots of hoping that I will get better and stay well long enough for us to consider a return. I will probably see him again in a few months, all being well.

I left fairly pleased with the outcome. Dr R seemed to understand my predicament and agreed that I wasn’t ready to return. I am a lot more worried about my future though. He was genuinely concerned that I will end up jobless and moneyless. At the moment financially we can cope with being on sick leave, but if I lost my PHI payment or ESA then we’d really struggle. I am comfortable with the fact I have a job to go back to with a company that has treated me well. I’m pretty scared that this might change. I don’t know how I’d find a new job and try and get back to work all at the same time.

The report arrived last week and was pretty much as I’d expected. My HR rep seemed fairly happy with the report, although perhaps a little disappointed that I am not ready to return. She called me today to find out if there was anything else she could do to support me. I have been given a contact in the Manchester office now and I’m meant to be talking to her tomorrow. It was suggested that I talk to her about things I can do in the Manchester office to give me something to do and to give me a taste of work. I need to build up my confidence and remind myself that I can actually do that job. I worry that I’ve lost my ability to work. I am not as sharp any more. I’m so slow and unproductive. I struggle to concentrate and think. I worry I will just not be up to the job.

We will see. If I am to get through all of this I need to go back. I loved that job and I want to go back. I just hope that I can. I am very scared that I won’t.

Disappearing Posts…

with 5 comments

Some of you may have noticed that my posts disappeared yesterday for a while. My bloke and I had an argument and in order to hurt me, he signed into here and deleted my blog. Thankfully he had the nouse to back it up first, but I was still upset and felt violated.

I saw Dr N this morning. As always it was good to see him. He always gives me time and is understanding. We talked about various things, including the arguing and anger, work and the CMHT. I got my script and I now have my melatonin so here’s hoping I get a decent nights sleep soon.

He is still keen for me to go back to work, but I just don’t know how I can. I am still as low as I was last May when I was signed off initially. I can’t handle even the smallest thing and I just snap and lash out. I’m worried the stress would tip me over the edge and I’d end up hurting someone or killing myself. Last night I dreamt I was at work and I hit my old boss. It was horrible. I hate that vision of myself and worse, I know it is close to reality. I suspect I wouldn’t last a week, even on part-time hours. I really don’t want to go back before I’m ready, yet I don’t know if I will ever know when I’m ready. The longer I leave it, the harder it is getting.

I am getting frustrated at being left behind and the way this illness has ruined my career. If I’d been well I’d be promoted this September. I am being left behind by my colleagues that started with me. Even worse, people that started after me and who were not as good at their job as me are being promoted ahead of me. I feel like a failure.

I fear returning to work and people’s thoughts about me. I fear the questions about my absence. I fear people’s confusion over why I’ve been in the company over 2 years, but have not been promoted to the next level. I fear people will think I’m useless because of that.

So far I’ve had some fairly negative reactions to my time off from work due to illness and that both upsets and worries me. I feel that I’ve lost people’s respect. What if I can’t find a new project because every manager is too worried about my sickness record? What if they treat me differently?

There is part of me though that is dying to go back. I want to get out of the house and start my life again. I want the freedom and independance that work will give me. I want the social life that work gave me. I want the daily routine. I want a reason to carry on. I’m fed up of this illness ruining my life. I want to go back and be better than ever.

I know that going back would not be the same. I loved my old job, but this wouldn’t be my old job. I will be working on a new project with new people. At first I will not even be on a project, which will be strange and difficult. I don’t want to return to a watered down version. A phased return would be painful for me, even though I know it is for the best. I want an exciting project and want to be in the thick of things. I don’t want to do pointless activities for the sake of it. I don’t want to be stuck in the Manchester office all the time. I don’t want to be learning how to do my job again. I am worried I just won’t be as good at it as I used to be. I am not as sharp and find everything so difficult.

When I went back to my old role for a few days last August, I found it unbearable not being able to do my old job. I found it unbearable knowing that someone else was now in control. I won’t be going back to the same project this time, so maybe that won’t be a problem, but then I’m scared about starting over again with something new.

There are also the small issues of the finance side of things. If I go back my permanent health insurance would be stopped. Initially it is complicated as I won’t be working full hours, but I’d be on some form of pro-rata pay. Also I’m currently applying for ESA. If I tried to go back to work and found I couldn’t manage it, I wouldn’t be eligible to claim again for another 28 weeks. It’s not exactly an incentive to try and go back before you are ready.

I guess we shall see what happens. I am signed off for another 6 weeks or so anyway so won’t be deciding before then. Dr G said yesterday she doesn’t think we can consider it until at least the end of September and I’m not sure I’ll be ready then. I will also have to attend an Occupational Health appointment before they let me back. OH of course might decide that I’m not well enough anyway.

Written by intothesystem

Thursday, 13th August 2009 at 12:36 pm

Going Backwards…

with 4 comments

So I’m back to where I was 7 weeks ago. I’ve just returned to my GP and have been signed off again. The appointment didn’t go as I’d hoped. The second I walked in the door, I was reminded of how frustrated she makes me. I had written a lot of stuff down, but failed to share it with her. I just couldn’t bring myself to show her and the paper remained screwed up in my handbag, unread. I go in there and feel flustered and rushed and unable to explain things. I lose all semblance of coherence and talk utter rubbish. She makes me feel patronised and pathetic.

I did manage to talk a little about my agitated mood. She suggested the agitation could be a side effect of the medication, but wanted to persevere with them, telling me they can take a month or so to settle down. I am unconvinced. I feel the same way that I did a couple of months back, long before I was medicated. I am not sure I convinced her how frustrated this makes me feel. I am not sure she realises the extent of this mood. I know I failed to mention the s-word again.

We talked about work and HR’s worries. I suggested part-time work and she seemed reluctant. She seems to have this theory that if you’re fit to work, then you work, if you’re not fit, you don’t. She doesn’t seem to like the idea of a phased return or working a bit. I tried to explain that I think it would help. Doing nothing drives me mad, but she just told me I wasn’t up to it. I’m not sure I’ll listen though – need to talk to HR and see what they say instead.

In the end, I was shuttled off with my prescription for the next month’s worth of pills, a sick note for the next 2 weeks and an instruction to see her again. I tried to book the next appointment, but she’s on holiday. I’m glad. I think the receptionist was taken aback by my keenness to see someone else instead! A new doctor has started at the practice so I will see him in 2 weeks time. I just hope I can be more honest with him than I can with her. I just hope I can get through the next 2 weeks to actually see him. I’m not 100% sure I can. I know I have to take things a bit at a time.

One thing I’d been worried about, was the fact I still haven’t been completely honest with my partner over the past few days, or even weeks. Although he knows I’ve been off and knows I’m still not better, I know that I’ve maintained the front I have always had. I know that I’ve hidden the worst from him and made out that everything was okay, even if it wasn’t. He doesn’t know that I have a secret stash of pills, there for if I need them, let alone how close I find myself getting to needing them.

After the doctors I talked to him briefly. I let him know I’d been signed off again and I think he was surprised. I tried to explain things weren’t as better as I’d made out, telling him I’ve been struggling to concentrate with work and feeling agitated again. He doesn’t think a lack of concentration is cause for concern, pointing out that everyone has trouble concentrating at work and he joked that he’d like to be signed off for it! I don’t think he understood what I meant, although I did say that things are like how they were before I was signed off and I think he might get it now. I’m not convinced though. At least I can try and shake off the guilt a little. I’ve tried.

I don’t know what my next steps are. For now, I’ve told my manager and I’m waiting on HR. What is next though, I really don’t know.