Into the system…

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Posts Tagged ‘severe depression

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.

*Sigh*…

with 4 comments

I don’t really know what to say. I have posts I want to write about specific topics, but I don’t know where to start. Head is a bit fried really and I’m just so unbelievably exhausted.

My social worker came yesterday. I had forgotten she was coming and had a bit of a panic when my phone alarm went off. To put it bluntly, she really is full of shit. She spouted all this stuff about positive thoughts and recreating brain pathways and activating synapses, when she clearly had no idea what she was talking about. She was basically waving the CBT stick at me, but tried to dress it all up in technical language and scientific explanations. I am fed up of her suggesting that all my problems will be fixed if I just apply some CBT, think positively and buck my ideas up. I have done a lot of CBT in the past, most of which is common sense. I’ve been applying CBT methods myself most of my life, long before I even knew what CBT was. How do you think I managed to cope with the depression of my childhood, teens and university years? Things have got worse and these methods just aren’t enough any more. CBT doesn’t work for everyone. There is limited evidence to suggest that CBT works with Bipolar Disorder and severe depression (and apparently that’s what it is) anyway, but still they persist. Maybe if I just try that little bit harder it will? Maybe it’s my fault it doesn’t?

Yesterday, I also managed to cut my wrist. This was an accident involving some wire netting and our fish tank. It’s a clean cut, about two inches long, right across the top of my wrist. The blood poured and I felt this massive urge to make more. I’ve not self harmed at all for a couple of months,  but it was a clear trigger. I’ve never really cut. A couple of times perhaps, but it’s not my chosen method of self harm.

When I was last self harming I don’t think I wrote about it, not wanting to alert my partner to the fact. There was a hammer lying around the house, not put back in the garage after some DIY. I was routinely hitting myself with it, all over my body. Sometimes it would bruise, but these could easily be blamed on the dog. She’s bruised me herself enough times. Other times it hurt like hell, yet didn’t leave a mark.

I can’t remember why I started again. I just felt the need one day in the summer, saw the hammer and that was it. Actually I don’t know if the hammer or the need came first. Maybe I was triggered by it then.

This seemed to help for a while. It released some frustration. Things carried on for a couple of months, but then it stopped as quickly as it started. Again I don’t know why. Soon after, we tidied the garage and the hammer went back.

Now I am struggling with the urge again. I want to hurt myself. I don’t know why. I don’t even think it would help. I just want to do it. I have resisted so far and I will keep resisting but the thought is niggling away. I wonder if I will ever get away from the temptation to hurt. I seem to stop and start without rhyme nor reason.

Written by intothesystem

Tuesday, 17th November 2009 at 1:19 pm

Recovery, Scoring and ESA…

with 8 comments

It’s been a strange week really. I seem to have spent the week being confronted with the fact I’m still a lot more ill than I thought I was.

On Wednesday I had an appointment with Dr B. He’s another GP at my local practice and as Dr N is on holiday for two weeks I had to make do with him. He’s okay, but a little brisk. Every time I’ve seen him he’s made me do a PHQ9 form to assess my levels of depression. It’s similar to a BDI I guess, but with fewer questions and less detail. My score was in the twenties (out of 27), putting me in the severely depressed category. I knew I was still depressed but I’d kinda expected it to have moved into the moderately severe category by now. I do feel better than I did back in February. The depression is less absolute, but I can’t deny that I still think of death and suicide every day, I’m still not sleeping and I still feel pretty tired and down.

For curiosity’s sake I did a BDI as well. I ended up doing it twice as I find it so difficult to decide between answers. My pessimistic score (choosing the worse option if I couldn’t decide) was well over 50. My optimistic score (choosing the better option) was about 45. 30+ is classed as severe depression so it’s a pretty similar result to the PHQ9. It’s a vast improvement on the 60+ (out of 63!) I was scoring in February. I racked up one of the highest scores ever seen at The Priory back then, which is pretty scary really. The improvement is not enough though. How can this be recovery if I’m still in the severely ill category?

I don’t know if I am really severely depressed though, even if my scores say I am. I have been depressed for so much of my life I’m not sure if my results are skewed. I expect even when I’m what I’d describe as well, I’d still be scoring a mild depression score at least.

I was talking about this with a medic friend last night. We were talking about the GPs in the village and I mentioned I’d seen Dr B. She asked me what he was like and I basically said he was okay, but he asks me to do the PHQ9 whenever I see him. She said that GPs are obliged to demonstrate they are giving “adequate monitoring” to depression patients and the PHQ9 counts towards this. It’s interesting as I don’t remember ever doing one with Dr N. I guess he prefers to give adequate monitoring with actually asking me how I am, rather than getting me to select ticky boxes.

I mentioned my scores and how I wasn’t sure how accurate they were. She suggested that sometimes the scores can be a little skewed by insight and they often don’t reflect how well someone is functioning, which seems fair enough I guess. She said I’m clearly functioning a lot better than my scores suggest, which I think is true, but I guess that comes with years of practice in hiding things. I function in autopilot, hiding the thoughts, but the thoughts are still there.

To add further doubts to my idea of recovery I got a letter from the ESA decision maker yesterday. They are finally processing my application under the youth rules and the decision maker has sent the sheet explaining how much I will receive. Looking at it, I’m being paid the amount pertaining to the Support Group. I presume this means they have my medical result and not only have I passed, but I am deemed too unwell to even contemplate work and thus have been placed in the Support Group. This is a big surprise. I had worried so much that I wouldn’t even pass the medical, let alone be placed in the Support Group. I haven’t received the letter confirming my medical result yet, so I wouldn’t be surprised if this is wrong, but it shouldn’t be. I will be interested to see what score I actually received. Another set of points telling me how ill I am.

I don’t know how I feel about being in the Support Group though. In a way it is positive. It means I don’t need to do the pointless Pathways to Work interviews and I also get a little more money, which of course is good. It means there is no pressure to try and get back to work before I am ready. I will not be bullied by the DWP to do so.

At the same time though I can’t help but feel disappointed. I feel like I’ve been written off. I am too ill and disabled to even consider working. That’s something I can’t handle and really don’t want to admit. I want to get back to work and I want that to be something achievable in the near future. It makes me feel like this is all pointless. I want to be recovering and this makes me wonder if I really am. I had felt I was making progress, but that progress is clearly not enough. This is all just fuelling the “fuck it, this isn’t worth it” thoughts. I don’t want this.

I’m a little worried too and I almost feel guilty. I wonder whether this is the right decision. I kinda feel like I have cheated the system because I didn’t expect to pass the medical. I know how notorious these medicals are. I know that hardly anyone passes, let alone gets placed in the Support Group. I wonder why I have got through when so many others haven’t? Am I really that bad? I know I can be in denial and I guess in a way these doubts show that, but I am still unsure. It just feels a little wrong.

I wonder if this process is designed to make you feel guilty? There is such a stigma against incapacity benefits, that you feel awful to be claiming them, yet if you are entitled to, it would be stupid not to. There is so much attention paid to people that cheat the system that genuine claimants worry they will be tarred with the same brush. I had no intention of cheating the system and I didn’t do anything to do so. If anything I down played how bad things were. There was no exaggeration, yet I feel like I have cheated. Surely this is wrong? Surely I should just be glad that the right decision has been made? Yet the doctors at Atos have such a bad reputation I even question a positive decision.