Into the system…

blogging, work, mental health, therapy, disability, benefits and more…

Posts Tagged ‘Social Worker

Social Work & Work Social…

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My social worker / care co-ordinator came to see me for the very last time on Wednesday. I wasn’t expecting to see her again at all, but she had some paperwork to give me. It was nice to get the call on Tuesday to say she was going to be popping over. I am sad to see her go. She was far better than my previous worker, J and she did restore my faith a little that there was a point in the CMHT. I am not quite sure how it is going to work without a social worker, but my psych is going to act as care co-ordinator, so it should be okay.

On Thursday I braved the work social. I wasn’t sure about going and got quite nervous about this. It was suggested I went along as a way of getting back in touch with work in an informal way. Sort of dipping my toe in. I was worried what I would say to people. I was worried what people would think and I was quite concerned about the fact I’m still on sick leave, yet I’m well enough to go out and get drunk. Would anyone understand that?

When I arrived, virtually no one was there, so I could get talking to a couple of people and break myself in gently. The person who was assigned as a sort-of mentor was there too, so she could kinda look after me. There wasn’t a big turnout at all really, so that helped as I guess I wasn’t going to burn too many bridges if I made a pigs ear of things. I didn’t really know what to say, but I ended up just being honest about being on sick leave. When we were talking about projects, when we joined and who else we knew, it would have been pretty hard to lie. I didn’t have a project and hadn’t done for almost 2 years – in which time my old project has become obsolete. I joined 3 years ago, in which time I should have been promoted. All the people I knew are now consultants or above or have left the company, so people would wonder why I didn’t know anyone else. I didn’t specify why I’d been off though. I thought about it, but it was easier to just say I’d been off for two years and that I’d spent some of the time in hospital.

In the end I coped, but I felt a little weird about it all. I kinda felt like I didn’t fit in any more. In some ways it was fine. I am still a young graduate, with the skills and knowledge to do the job and the aspirations to do well, get promoted etc. I am no different to the rest of them in that respect. I think I can still do the job, but I am not so sure about the company culture now. I used to love it, but the work hard, play hard thing may be a challenge, because I can’t really do either. To do so, would be risking further illness. Socials are built around drinking and late nights, neither of which are a great idea – alcohol is a depressant and I need routine and sleep. Success is built around how many hours you put in, never saying no, high standards and perfectionism – I guess the same is true for many jobs, but there is a huge amount of competition and one-up-man-ship. There is a constant need to prove yourself to be better than the next person. I can’t push myself to breaking point again. I have to hold back, as hard as I am going to find that. With work encouraging me to actively not hold back, that may be difficult to control. I think occupational health and HR will have a close eye on me and will do what they can to protect me from that, but I am not sure I want to be in that position. I don’t want to be left behind. It feels hard enough as it is.

At one point, one of the girls mentioned someone she had met in the company who had been an Analyst for 5 years and she was basically insulting this guy for the amount of time he had been at level. When she said this, everyone except me laughed. She suggested that he had some form of learning difficulties, which meant he didn’t get given enough responsibility to be promoted. Although this may be true, it was meant to be an insult, suggesting he was a massive failure and terribly flawed. Are people going to be saying the same things behind my back? At the end of the summer I will be entering my fourth year as an analyst. Most people are promoted in 2-3 years and many have been promoted again within 5 years total, so I’m a long way behind already. It is highly unlikely I will get promoted in the next year or so as I will not not be working full hours or full responsibilities for a long time. So I am going to become this guy – an analyst for 5 years or more and ridiculed because of it. I am scared of this.

A lot of the time I wonder if it would be easier to start again completely. A new job and a new life. My old life has left me behind and things have changed so much they will never be the same again. I am scared of going back and trying to fit in. I don’t quite know if I will fit any more. I am scared of explaining what has happened in the past two years. I want to erase the past two years, so I can just start again where I left off. I want to catch up with everyone else and I know that is impossible.

There are advantages to staying put though. My company have looked after me and I feel I owe them some loyalty for that. They are going to be flexible with my return to work and will continue to look out for me. I don’t have to learn a new job and at least I already know what to do. The company’s expectations of me have been lowered, so there is no pressure to live up to anything. I don’t need to perform at my best. I can go at 90% and hopefully that will be enough for now.

Starting again obviously has its pitfalls as well. I couldn’t start a new job. I would work too hard trying to keep my head above water, trying to be perfect, trying to impress. I would have to meet new people, with all this history and baggage behind me to try and explain or ignore. I’d have to learn how to do a new job too – new skills, tasks, routines. I am not sure I am up to learning much at the moment. My thinking still isn’t as sharp as it used to be. My memory is crap, my concentration isn’t brilliant. I would end up burning out in no time and I’d be back where I was before. More time on sick leave and another attempt to return to work. No one in their right mind would employ me now anyway, so it is not an option anyway, but I just wish that going back would be easier.

I am starting to realise that although my mood has picked up now and I feel relatively stable, there is still a very long way to go before I can say I am recovered. The future is scary. I have a lot of things ahead that will try and trip me up and I’m a little scared about embarking on this part of the journey. I don’t want to slide back down the hill, but the baggage I’ve got to carry along the way is going to make it pretty tough going.

I feel like I’m kinda rooted to the spot for now, looking up at this big hill with a feeling of trepidation. I’m also being held back by occupational health and my doctors, so I can’t even just take a big breath and have a run at it. All I can do is keep plodding though and hope that one day I’ll be able to get there.

In other news – I’m off to Glastonbury on Tuesday night, so I probably won’t blog again, even though I have two other posts in draft. They can wait though. See you all in a week or so.

p.s. I’ve updated the My Story page again. Can’t believe it didn’t even cover my admission back in January. A lot has happened in 6 months.

On my own…

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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.

Day 5…

with 5 comments

in the nuthouse (not the godawful Big Brother one).

I’m updating purely for something to do. I don’t think anything is going to happen today. No visitors and no ward round.

My ward round yesterday was strange. The usual scary NHS experience of a room full of people and not having any idea who most of them were. It’s not like we have any occupation or therapy here so there can’t even be OTs. Unless there were and they just do nothing! I was too nervous and hyper to ask who they were or remember if they told me their names.

I was interviewed by a psych whose job title I cannot remember, but Dr M was there too and interjected now and then. I was so nervous, that mixed with the hypomania, I became pretty incoherent, speaking so fast they were grappling to keep up. I started by trying to lay down my guidelines – respect, not being patronised and being informed. Not sure how much they listened. I was asked and talked about my diagnosis and how it came about, when I first sought help and what happened following, my last admission here, ECT, The Priory, medication and more. I talked so so much in the half hour that I became hoarse and barely stopped for breath. Felt like both hours due to the amount covered and minutes due to speed! At the end they decided that they needed more time to read my notes and discuss before they did anything and suggested that they would call me back in later so they could give me an idea of the plan. I agreed to this.

Sadly later never came. I don’t know if this is because of what happened afterwards. At 1.30 which was my original appointment time my useless social worker, J turned up uninvited and apparently unannounced. I had been asked if I wanted her there and said no, which is why they could change my time to this morning. The nurses seemed to be as confused as I was when she arrived. J saw me and proceeded to wind me up, which as I was already agitated was not helpful at all. She basically suggested I have made bad choices to end up here and it is all my fault. She doesn’t seem to recognise or acknowledge mental illness despite it being her job. She moaned about not going in ward round with me, ignoring the fact I didn’t ask her to come. Apparently it is just what happens. Well no it isn’t if I am asked and say no, surely? She then asked to see the doctor and went in without me. I am angry about this because I explicitly asked to be treated like an adult and be kept informed, but I was not involved in this conversation. I don’t know what was said, but she came out and told me they intend to RE-assess me next week before they decide to write my CPA or do anything. I got the impression I would not be involved in this latter process. She then left saying she will be checking exactly when my next ward round was so she can be there. I didn’t seem to have a choice in this matter and it seems they are generally weekly. No wonder no one gets out very fast with all this waiting to be seen.

I still hoped I would see the doctor again and they would have a plan for me, but it didn’t happen. I fear they decided just to talk to J and not bother with me, despite my wishes.

I am concerned by the mention of reassessment. Surely that is what happened yesterday? Admittedly I was hypomanic so it may not have been as clear as they would like, but for all they know I could be very manic by next week and they can’t reassess me every week before they do anything. I could be here forever. I also worry it means they do not trust or believe me. I have been feeling a little paranoid.

I moaned about J a lot to my bloke when she’d gone and said I wanted to change. He called the CMHT afterwards. Told J’s manager I wasn’t happy and hadn’t been for a while. Apparently they are meeting today to discuss and consider someone else. I’ve not been informed by anyone here about this yet, just by the bloke. Another sign of being ignored.

They asked if I wanted to complain formally. I was unsure about this, but have been encouraged by my bloke to write a letter, which I did last night. It is probably too long, but there have been so many niggling problems, as well as her general attitude, it was hard to express things. That and hypomania leads to verbiosity.

I feel a lot less hyper and giddy this morning and may be starting to come down a little. Kinda in two minds about this. Some of the hypomania has felt pretty good over the last couple days. Writing and writing. Not feeling tired. Things feeling bright and fast. It makes a change to numbing depression. But, and there is a but, I was worried about how I was coming across. It may have been to blame for the lack of response in ward round. I have also worried about things turning really nasty and the background thoughts becoming louder whilst still having this energy. Although my mood is mixed, the hypomania has been dominant meaning it is less bad.

Now I feel a little agitated, but mainly unable to think. Numb and bored. Frustrated. Wish I knew what was happening.

Written by intothesystem

Wednesday, 13th January 2010 at 9:59 am

Waste of Time…

with 15 comments

So I saw Dr D today for the second time. My social worker came in with me, along with a junior doctor who looked about 12.

I didn’t know where to start. I had taken some notes with me which helped a little, but I’m not sure how much he actually paid attention. I ended up having to explain most of my notes when he questioned me.

It seems he doesn’t really know what to do with me. He asked about antidepressants again, but when I reeled off the list of medication I’ve tried, he said I’ve pretty much exhausted the list. He decided to just leave my meds as they are. I’m a little disappointed about this. Although my current medication regime is the best combination so far (as in I haven’t gone *completely* batshit crazy on it), it’s hardly doing the job. I was hoping he’d have a suggestion of something else we could add. It just feels that by leaving the meds as they are, nothing is being done to try and improve things.

I brought up the subject of work and when I was likely to go back. He told me I’m still very ill and that I shouldn’t try to run before I can walk. Clichéd I know. I still find it weird when I’m told that I’m seriously ill. I guess as much as I do know differently, I still have those niggling thoughts that mental illness isn’t real illness. Everyone else’s prejudices still rub off on your subconscious.

I tried to push the subject saying that work were interested to know when I was likely to start a return to work. He just told me not to think about work. He just said the usual things about mental illness not having any exact time-scales. Apparently the CMHT are trying to get me better as fast as they can. I’m not exactly convinced. It feels like nothing has been done to try and get me better so far.

I also brought up driving and he just reiterated the need for me to be “stable”. He didn’t give any indication of what that means, just that I am not well enough to drive at the moment. Apparently all of these things will just happen when I am well again and I shouldn’t think about them. Easier said than done.

I mentioned the EAP therapy and he agreed that it might be helpful for me to have some support whilst waiting for the Enhanced Day Therapies referral to come through. Useless social worker, J was meant to chase up my EDT referral but hasn’t, so we shall see if she does it now she’s been reminded by Dr D. I think he was quite pleased to hear this about temporary therapy because it meant he didn’t have to do anything now himself!

The appointment didn’t last long and just felt like a complete waste of time. Apparently I will see him again early next year. No doubt it will be more of the same.

Regarding the EAP service. Yesterday, I was contacted by one of their counsellors to book an appointment. Unfortunately they were based in Liverpool, which is a two hour trek by bus from here (train would cost me money, bus is free!). I contacted the EAP today to ask if there was anyone I could see in Manchester. They’d linked me to someone in Liverpool because my address comes under Warrington, but Manchester is actually much easier and closer. Unfortunately all of their counsellors in Manchester are currently unavailable, but one comes back from holiday at the end of the week so they are going to ask them then. I guess we shall have to see what happens. If they can’t do it then I will probably give the Liverpool guy a go, but I’m not sure if it will be worth it with all the travelling.

Meh. I really feel crap now. Headache is raging (come on Propanolol! Work!!) and I just feel really demoralised by the crapness of the CMHT.

Written by intothesystem

Tuesday, 24th November 2009 at 6:31 pm

Doctors and EAPs…

with 6 comments

I saw Dr N on Thursday. It was good to have him back.

I wasn’t really with it at the appointment. I couldn’t focus and didn’t know what to say. I have felt pretty numb over the past few weeks and I couldn’t convey how I felt. At one point he just said “Are you okay? Have you been sleeping? You seem like you’re on another planet”. I told him that sleeping was a silly question, which he admitted, but he was right. I was very tired and vague. The fact he’d noticed though was good. It makes a change from other doctors that clearly pay no attention to how you really are.

I explained that I’d been having problems with headaches over the past couple months. I’ve literally had a headache every day for about 3 months, sometimes incredibly intense pain, other times just a dull ache, but nearly always there in some form. Beta Blockers are meant to be effective in preventing headaches, so he was a little concerned seeing as I’m already taking propanolol (for anxiety/agitation). We’ve decided to increase the dose and also switch to the modified release version so I’m now taking 160mg daily instead of 40mg b.d. Hopefully it will have some effect.

On Friday I got a phone call from HR. I have a new HR Rep, R. She introduced herself a couple of months ago, but hasn’t been in touch since. She was meant to call me regularly but hasn’t, so it was quite a long catch up. She asked me about therapy referrals, my social worker and psychiatrist. I told her there wasn’t much to say. Therapy referrals take forever, my social worker is still useless and I don’t see my psychiatrist until tomorrow.

She asked me when my last occupational health assessment was. It was over a year ago, so she said she will look into that again. I don’t know what an OH assessment will achieve. I get the impression they only want me to go so that work can say they are doing something to help. I don’t think there will be any pressure on me to get back to work, but I may be wrong. I guess it depends on the doctor I see. I have the same fears I had about the ESA medical. Fears they will tell me that I am making it all up and should just go to work.

If I do go, I wonder if I will see the same doctor as last time. He seemed to be pretty knowledgeable when it came to mental illness and was the first medic to suggest that Bipolar Disorder was a possibility. Shame it took a further 7 months before an agreement was reached on that topic. When I’d brought up his thoughts later with other doctors they didn’t seem interested. I guess they wanted to make their own decisions.

It may be useful to discuss work though. I haven’t managed to get much of an idea from the CMHT about when they think I will be ready to go to work. I am going to try and talk about it with the psych tomorrow. Dr N keeps asking me if I’ve heard anything from HR or whatever, but there hasn’t been anything to tell. I told him about my medical result too and I think he was a little surprised I’d been placed in the support group, although I think it also told him how ill I’d been on the day of the medical. I am not sure he quite understood how bad it was when I’d told him before.

The other thing R mentioned was regarding our company Employee Assistance Programme. I was told that they had been running a CBT trial and maybe I should consider asking about it. I told her I was pretty skeptical about CBT, but it could be useful to have some contact with a therapist whilst I am waiting for the NHS to do something. I agreed I’d give them a call anyway.

I was on the phone to the EAP for ages. First of all someone took my details and asked why I was calling. I explained I’d been told about CBT by my HR rep. She explained that they only offered telephone and online CBT (I’m guessing Beating The Blues!). I told her I wasn’t sure about that, but she said she’d put me through to the counselling team for an assessment and to discuss what might be helpful.

The counsellor was lovely. I explained I’d been on long-term sick leave for mental illness and that HR had suggested I got in touch. He asked me for a potted history, which I gave him as quickly as I could manage. At the end he just kinda went “oh, blimey”. I mentioned I’d had CBT whilst at The Priory and he asked me what I thought of it. I was honest and said that I was pretty skeptical and generally thought it was common sense, useful for mild depression, but ineffective for me. He asked me why I’d even bothered calling then, which was a sensible question. I said that I guess I thought it might be useful to have some contact with therapy whilst waiting for the NHS. Apparently his assessment of CBT was similar to mine and he didn’t think online CBT was going to be much help. He explained that usually a case like mine would be too complex for them to consider, but he wanted to help. He suggested that because I am waiting for long-term support, but I’m not getting the help I need currently, he felt it might be possible to refer me to the face-to-face service temporarily. It would only be four assessment appointments, but it might help me to work out what I want to work on when my NHS referral actually comes through. I agreed that this may be helpful. He asked me more questions then. Mainly about risk and safety. He stressed that his boss wouldn’t allow him to go through with it if they felt I was at too much risk. I had to give him the assurance I would be safe for the next four weeks, which was difficult even now. I am keeping myself safe at the moment, but I don’t know if or when that will change. At the end of the call he explained he would need to ask his boss to authorise my case, but hopefully it would be okay and then he wished me luck.

I am awaiting the phone call back to arrange my first appointment. He said if his line manager had refused he would call me back straight away and I didn’t hear anything, so I’m hopeful. I do think it could be good to just see someone for a few weeks. I don’t trust my social worker and have very little other support. In some ways I’m hoping it will be the same therapist I saw through the EAP back in April/May 2008, but I don’t suppose it will be, but you never know.

I need to go now. I have more to write, but no time. My bloke is going back to work part-time and I have the psychiatrist tomorrow. I guess I will update more soon.

*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

Limited Capability for Work?…

with 2 comments

A little less agitated than yesterday evening at the moment, but I’ve had a terrible night’s sleep. I was very wound up all night and couldn’t keep still. My head was flying all over the place. Every time I drifted into sleep I had busy, fast, vivid, strange dreams. I was waking up from them every 30 minutes or so and wondering why I wasn’t doing all the things I was dreaming about and then I couldn’t get back to sleep because my mind was flying off on all these tangents inspired by the dreams. Things eventually seemed to calm down a little around 6-7am, so I did get a couple hours of sleep, but even then my sleep was littered with more dreams.

Part of this agitation may have been exacerbated by the argument I had with my partner last night. The night before I am due to go for an ESA medical, testing whether or not I am fit for work, he tells me I should just go back to work and implies that I am lazy, a skiver and not ill at all. This isn’t helpful.

He was telling me that I should just go back because unless I do, I’ll never be ready. He thinks I am just putting it off forever. He thinks I need to go back and try to work because until I do I can’t be sure if I am ready or not. This is of course true, but I think I need to be showing more signs of being ready before I try it.

There are of course a lot of things to lose by going back too soon and then having to stop working. The loss of my permanent health insurance income being one. I’d have to apply again for it, which is a lengthy process. The loss of ESA will be another factor, if of course they ever give me it. As I am claiming under youth rules I’d have to be off sick for another 6 months before I can claim again.

I suspect that he may in part be pushing me back for selfish reasons. He has of course given up a lot to look after me, but I think it is wearing thin and he doesn’t want to stay at home and care for me any more. I pointed out to him that if I am ready enough to go back to work then he shouldn’t need to care for me anyway and should just go out and get himself another job, but he didn’t seem to agree. The fact he still thinks I can’t be left on my own must tell him I can’t be expected to work. I would likely be on my own a lot in the office and there’s also the matter of getting to and from work. It would be easy to abscond.

My social worker seems to have a strange attitude to my employment. She was asking me if my goal for recovery is to get back to work. For me, the ultimate goal is being well enough to work again and more importantly for me, to go back to the job I loved doing. She seemed disappointed with this and almost surprised. It really felt as if she thought I shouldn’t expect to work again because of my mental health. Maybe she just feels I shouldn’t be working in a high-pressure, highly competitive environment, but for me, working in a simpler job wouldn’t be recovery. It would seem like a poor compromise.

To me her attitude to work seems bizarre. Surely her goal should be for me to return to a normal life, or at least as normal life as possible? I don’t think it should be expected that I will remain disabled and a full-time mental for life? I really fear that will happen and need as much help as possible to stop it happening. I know I have to face the fact that this illness isn’t going to go away and I will have to learn to live with it, but I hope that I will be living a fuller life than this sometime soon.

At the moment I don’t think I’m ready to go back to work. This sudden swing into agitation is a suggestion of that. Last time I tried to return to work I became very hypomanic, very quickly, probably aided by the fluoxetine I was on at the time. Work is likely to fuel this mood and send me up and up. Maybe that would be nice, but I’m not sure I’d be a productive employee.

Even if I hadn’t have entered this mood yesterday, I don’t think I’m ready yet. I am still battling suicidal thoughts almost constantly. Stress would only make these thoughts more urgent and amplify the need to escape this world.

There is also the matter of anger management. I’m not there yet. I have calmed down on a month or two ago, but I am still struggling with bubbling agitation. The smallest thing can send me into rage, wanting to hurt both myself and the cause of the anger. I have to admit I can’t take criticism. It was something I found hard before, but I usually turned it on myself mentally. Lately I’ve been literally hitting back and that is not suitable behaviour for work. I don’t want to be violent and I certainly don’t want to display that in the workplace. It would do nothing for reducing the stigma that mentally ill people are dangerous.

It is these things that I’ll be talking about today at the medical. I need to convince them I shouldn’t be working, yet I’m doubting this myself. I hate being hypocritical. I guess if I do get through the medical it is proof that I shouldn’t be working. If I can convince the DWP, who are notoriously bad at trying to get people back to work before they are ready, then I really must be ill. We will see. I don’t hold my breath.

There is a voice that tells me I am a fraud and I should just go back to work. I feel lazy, sitting around having nothing to do all day. I am trying to occupy myself, but I am not a productive member of society.

I am getting stuff done, but this only makes me think I should be working. Over the past couple of days I’ve embarked on a project to sort out all of my photos and to get them online. I used to have a photo gallery on my website, but I took it down when the domain was up to expire and since uni I’ve been very lazy about my photography. I have literally thousands of images, over 40gb worth. A lot of these are utter rubbish, but I want to find the ones that aren’t and get them out in the open. Anyway, the point of this is I’ve been sitting on my computer sorting this photos out and generally I’ve been able to concentrate on the task in hand. Considering a vast amount of my job is sitting at a computer then maybe I should be doing that and not just sorting out my photos.

I’ve been baking more recently and on Tuesday, I also made a load of home-made chocolates. I managed to do it successfully this time after a recent attempt involved me using semolina instead of sugar. Unsurprisingly the mixture had to go in the bin. They were popular at creative remedies yesterday, with many suggestions of having to sell them or give them as christmas presents.

I had even ventured back into the world of books and reading over the past month or so. I haven’t picked up a book for a couple of weeks, but I was getting there. I was reading stuff and even starting to enjoy it a little. I sometimes had to read paragraphs multiple times or forgot what I had been reading the previous day, but I was getting through the pages.

I also worry about this blog. The fact I can sit here and read and write. Does that mean I should be working instead of just writing about the fact I’m not? If people found this, would they use it against me to tell me I should be working?

This desire to work has of course has been amplified by my mood since yesterday. I have all these ideas of things I could be doing at work. I will not be on a project at first so need to find some internal work I could be doing. I can think of so many ways to improve our company. So many things that could be done and I want to be the person to do them.

There are barriers to returning. My doctors tell me I’m not ready. My social worker tells me I’m not ready. I need to go to occupational health before they will let me go back to work and they may well tell me I’m not ready. When will I know if I’m ready? How can they know?