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Posts Tagged ‘safety

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.

Days pass by…

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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!

Another Bad Night…

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Last night was just another bad night of many recently. I couldn’t sleep, mainly because I felt physically awful, but also because there was a lot rolling around my mind. Little positive unfortunately.

Morning rolled around and I still felt terrible, so forcing myself out of bed really didn’t seem like a good idea. I just couldn’t face more therapy on top of the dizziness and stomach ache I was struggling with, so I decided not to head to The Priory today. Art Therapy this afternoon had been cancelled anyway as the therapist is away.

Afternoon arrived and I got up, but could only manage an hour or so before escaping back to bed. I had to get up eventually though mid-afternoon as there were things that needed doing and I had an appointment with my GP, Dr N.

The appointment was similar to usual. I wasn’t honest enough again, but I don’t know if I need to be anymore. They seem to realise that things are pretty bad. He asked me if I wanted to get better, and although I do, I confessed I sometimes find it hard. I just want everything to go away. He told me to stay safe. I wonder why they keep telling me that.

He gave me my scripts. 2 weeks this time, but he basically told me that 2 weeks of my new baby starting dose of Lamotrigine (25mg) is not enough to hurt a cat, let alone me, so told me not to bother. The silly thing is I’d already checked and knew that.

Tonight, I’ve been left alone whilst my partner is out for a few hours. I should feel the freedom and relish it, but I am just left disappointed that I feel so physically crap I can’t make the most of it. I am also bound by the dog and the fact my car is at the garage (even worse than not knowing where my keys are). I took the dog for a short walk, but didn’t feel very well doing it. My head was spinning and the strain of trying to get a 16 week old puppy to go where you want to was getting to me. I just wanted it to be over. It’s stupid that things like that left me not just wanting the walk to be over, but wanting everything to be over. That is the way things are at the moment.

Earlier this week, I had a plan for tonight. A plan I’ve not been able to realise. When asked if I was going to be safe on my own tonight I had always said yes. When asked if I had a plan and had set a date I had always said no. The truth was, I had a plan and today was the date.

All last night I was thinking about it. All last night I was thinking about whether or not it would work, whether there were any better options, whether or not I’d feel physically up to carrying it out, whether or not I’d be mentally up to it. I guess it is no wonder I didn’t sleep very well.

Today though has not gone to plan. I was missing some of the means and the physical strength to do it. I think it is hard to think about doing anything when you feel so physically crap that all you want to do is go to bed.

I am left disappointed and sad. I am left frustrated. I still wanted to do it tonight. It is too late now, but I find myself regretful. I should have done it. I should have just stuck to the plan. I feel weird. I didn’t see a future beyond today, so tomorrow will be strange. A day that I had not intended on seeing. I don’t know what to do with it.

Feeling Vague…

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I’ve not really been here over the past couple days. I feel very vague and am completely utterly exhausted. I don’t really know what to say. There are things floating around in my head but it’s so foggy and useless at the moment I don’t think I can begin to form sentences and write a proper blog entry. Another day perhaps.

I just feel overwhelmed by everything at the moment. I don’t know why. This week is scaring me. Too many meetings, med changes, doctors to see, phone calls to make, things to do, plans to write… It’s going to be a nightmare. All this preparation for discharge is too much for me.

I can’t comprehend leaving The Priory at the moment. It’s scary. I’ve been here almost 9 weeks now and I don’t know how I can cope with anything else. Normal life exhausts me. I just can’t handle it. I’m so institutionalised and I am safe in my little bubble. The outside world is a whole different ball game and I’m not sure I can do it right now. I can barely do this safe dependant life, let alone my life in the real world. Meep.

Written by intothesystem

Sunday, 19th April 2009 at 8:51 pm

London Bound…

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I’m traveling down to London this weekend for a friend’s birthday. I’m sat in the first class lounge waiting for my train at the moment. I am glad I booked a first class ticket. It’s far more civilised than cattle class.

I’m a little apprehensive. I had to promise I would keep myself safe this weekend and although I said I would, I don’t know if I can 100% guarantee that. I hate that I can’t promise and know for sure, hand on heart, that I will be safe. There is no guarantee that I won’t flip out and do something impulsive, but I’m hoping I won’t. I know I am putting myself in a situation where the temptation could be there, but I know I need to face it. My nurse on the ward would talk about empowerment and how I have to face it. I know that I’ve been okay up to now since I left the ward and I just have to keep it up, but this is my first weekend away on my own, so I hope it goes okay.

I looked at my thoughts around this in my CBT group this morning and it was helpful. The therapists worked with me to come up with some ideas and plans to put in place to make myself safer. I just wish I didn’t have to do that. I resent it. I did find the session helpful this morning. I just wish there wasn’t this negative commentary in my head counteracting every rational and sensible thought I have and making me want to rebel against the safety measures. I’m going to try and help myself. I really am, but I have to fight to stop my mind from undermining me.

The weekend should be enjoyable. I hope my depression doesn’t make that impossible. I will be staying with good friends and we have fun things planned. I just hope I can feel the enjoyment and not be too negative.

There are a few pitfalls I have to avoid. Tomorrow, I will see a lot of my work colleagues that do not know that I am ill and have been on sick leave for six months. They will be asking questions of me. What client have I been working on? Why wasn’t I at the last conference? etc. and I will need to respond. I think most of them are fine and I will probably be honest with them, but it still might be a bit weird. I certainly don’t want to bring the atmosphere down and talk about my illness when we should all be partying, but then I will have to give my justification for being very careful on the drink front. Just one or two makes me drunk on these meds and I know it does nothing for my mood, so I need to be careful.

I hate this illness. I hate how it means every situation needs thinking about. The risks need to be considered. I have to think about how I am going to keep myself safe. I wonder if I will enjoy things, when usually there would be no question. I worry about the consequences of things. I have to think about what would be best. I resent having to keep myself safe. I hate the fact that I don’t 100% trust myself. I hate that my partner doesn’t trust me and worries about me. I hate that my friends feel they need to keep an eye on me. I don’t want to be a burden and someone that needs to be looked after. I don’t want to think about these things.

I should be back on Monday.

From next week my therapy days change. I will be going Tuesdays and Fridays as opposed to Monday, Wednesday, Friday. There is an extra day to face, but I know I just have to do it.

November 4th: Out of the hospital…

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On November 4th, the 28 day limit on inpatient care was reached with my insurance, so I was to be discharged. I had spent the days prior to my discharge panicking about it, knowing I was no better than I was when I was admitted and worrying that I wouldn’t be safe. I did not want to be discharged. I felt safe on the ward and needed the support. It felt like my safety net was being whipped away before I was ready. I couldn’t comprehend life outside of the ward. It was too scary and daunting.

It was clear I wasn’t ready to leave and Dr G said she’d have ideally kept me in for a few more weeks, but it wasn’t to be. When ward round came around that morning, I was in a state. I couldn’t think straight, was shaking and could barely talk. Her words washed over me and I couldn’t comprehend leaving. I was disappointed that she didn’t seem to acknowledge my fear. I know she told me about what support was available to me afterwards, but it didn’t feel like enough to calm my fears. I was terrified.

Later, I met with the therapy coordinator, J and this was a big help in preparing me to leave. He managed to calm me down a little and helped me to accept that I would be leaving. We looked at the options for day care and talked about the things I could do to get extra support on the outside. Eventually we settled on a programme and I had time to pack and get ready to leave before my last therapy session.

I was sad about leaving. Although most people that I had made friends with had been discharged ahead of me, there were still people I knew I’d miss when I left. I didn’t really want to say goodbyes, so it was kinda convenient that my departure coincided with dinner and everyone was in the restaurant. We took my stuff through to the car and then I got ready to go.

It was very weird being free to leave, after spending the previous four weeks being escorted everywhere by a nurse. I had taken some leave whilst I was on the ward, so it wasn’t a completely new phenomena, but it was still quite strange. It left me in a daze and this was kinda how it felt for the next few days really. It’s weird when being at home feels like a strange experience, but that was how it was. I’m still getting used to it really.

Written by intothesystem

Monday, 17th November 2008 at 7:42 pm

Into the community…

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So I was discharged on Tuesday, following four weeks as an inpatient on a private acute psychiatric ward. I was not ready to be discharged, but my insurance had a 28 day inpatient limit, so there wasn’t much choice. I certainly can’t afford to self-fund!

So I’ve returned to the community and so far it feels a bit strange, but I’ve been okay. If I’d been chucked out on Monday there might have been a different story. My mood was on the floor, suicide the only thing I could think about. The same horrid scenario replayed over and over in my head, blocking out all my thoughts and stressing me out. I couldn’t comprehend leaving the ward in that state. Luckily, my mood picked up around Tuesday lunchtime and I’ve been “okay” since. Still low, still struggling to think, but not too bad. For once, my mood shifted at the right time!

In terms of where I am now. I’m still not formally diagnosed; this episode of illness just has the vague description of “depressive episode”. Whilst I was in hospital, I had two short periods of hypomania, demonstrating the clear shifts of mood I’ve been experiencing for most of this year, but this still hasn’t been enough to solicit a diagnosis. My psychiatrist is hedging her bets a little. She believes I do suffer from a mood disorder, but she is not being more specific than that. She said that the predominant picture is one of depression, but that this is complicated by the fact I do have obvious shifts of mood, suggesting that perhaps my diagnosis lies within the bipolar rather than unipolar spectrum. She is still uncertain though and won’t commit to this. She also added that my condition appears to be somewhat complex, due to added complications with my personality (perfectionism, passivity, workaholic). I suspect she is weighing up the decision to slap on a personality disorder diagnosis or two. I’m sure my symptoms could be moulded to satisfy one if she deemed fit. This lack of diagnosis is both frustrating and a relief. I am glad she isn’t rushing into things. I’m glad she hasn’t just wheeled out a diagnosis of borderline personality disorder because I self harm and have been difficult to treat. Yet, at the same time I wish she wasn’t being so vague. I want to know if I need to accept this is a chronic condition that I will be dealing with for the rest of my life. I suspect that it is, but I can maintain a state of denial until she confirms this for me. I want to know what it is I’m facing.

My current medication regime is as follows:
8am: 225mg Venlafaxine (Effexor XL) & 50mg Quetiapine (Seroquel).
4pm: 50mg Quetiapine
10pm: 250mg Quetiapine

So far, I am unsure how much it is helping or not. I suspect the Quetiapine is helping with my sleep. The drowsiness kicks in fairly soon after taking my nightly dose and although I am still waking fairly frequently and not feeling all that rested, I am definitely getting more than before. I think it is also helping to level me out a bit. My mood isn’t spiking as much as before, but just seems to swing between varying degrees of lowness, instead of going from very low to a little high. I started on a tiny dose, but almost every time I see her she adds more!

I do not know if the Venlafaxine is helping. My mood is predominantly low at the moment and the suicidal ideation is still around fairly often (which I guess could actually be the fault of the Venlafaxine – it has a reputation for increasing suicidal thoughts), so I suspect not, but then if I wasn’t on it would things be different? I wonder what her next move will be with this. She has upped my dose a few times to get to this point, but I suspect she won’t up it again.

I start day care tomorrow, attending Mondays, Wednesdays and Fridays for the next six weeks. I will be continuing with some of the groups that I attended as an inpatient and starting some new ones. I am looking forward to some of them, but apprehensive too. Therapy is hard work and often makes you feel worse, not better.

Tomorrow, I have group CBT and Expressive Therapy. I am still to be converted on the CBT front. I’m not sure CBT is all that helpful to me, but the group is quite good as there are two therapists, which ensures everyone gets some individual support. Expressive therapy is a bit like going to playgroup and is different every week. We may be painting, playing games, doing role plays, singing or whatever, but it’s usually quite fun. A bit of light relief for a Friday afternoon anyway.

It will be really good to see people again. I should get to see some of the people who were inpatients at the same time as me, as well as the day patients I’ve met in group. You find that you make close friends easily when you are in a hospital environment or group therapy situation. You learn things about people that you’d never share in the outside world and become intimate friends very quickly. The empathy between patients is something that’s hard to find elsewhere. The only other place I’ve really experienced it is in this blogging community. It’s not just between the general psychiatry patients (depression & anxiety) either. Even the addiction and eating disorder patients have that sense of shared experience and empathy. I do miss the fact I could just walk into the lounge and there would always be someone you could talk to that would really understand. I think so far, that is the hardest thing about being in the outside world.

Generally I think I should be safe over the next few days assuming my mood stays roughly like this. I’ve got a friend coming over this afternoon so that should be good. Although my bloke is out this evening I think I’ll be okay. It’s a bit weird being on my own after 4 weeks of almost constant supervision, but so far I’ve not been too worried. Tomorrow I am in day care, which I am looking forward to, although I’m a little worried about how I’ll feel when I go home after a day at the hospital. Therapy can be draining and it might leave me feeling weird without the safety net of the ward to go back to afterwards. The weekend brings visiting friends and bonfire night, so I should be suitably distracted throughout and Monday brings a return to day care and a review with my psychiatrist. I dread the review a little as I am terrible at getting my needs across, but I will try and prepare a little beforehand.

I’m not sure that “being safe” should be all I’m aiming for, but it is all it feels I can aim for at the moment. I guess I should be pleased that I can feel safe. It is an improvement. A couple of days ago I really didn’t think I’d be safe in this outside world and so far I have been. I am still uncertain though and still don’t trust myself completely. I think I do generally feel as if I may be existing for existence’s sake. That doesn’t make things easy. I get close to giving up more often than I probably should, but it is incredibly draining just going through life for, what feels like, the sake of it. I just have to keep telling myself it will be worth it. I just have to get through this period of crapness and hope for things to change. Not easy though.

Anyway, I have written enough for now. I will update on the weeks before my admission sometime soon, although I don’t really know where to start. It has been a crazy few months.