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Posts Tagged ‘stability

A little unstable…

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I have been quiet over the past month or so. I keep thinking “oh, I really must get around to writing that post”, but it never seems to happen. I do start posts, but somehow they never get finished and by the time I get around to it they have become irrelevant and I end up having to start again. I guess if I started writing shorter posts, it might not take me so long to finish them!

My last proper post (excluding the 2010 review) was pretty negative, but an accurate reflection of my mood at the time. Things have improved a since then, although they still feel a bit shaky. I felt really really awful for a few weeks, but Christmas was bearable and I was able to keep going without slipping any further, so that is encouraging. If that is as low as I get, I can survive, but I don’t know how much lower I could go without ending up back where I was a year or more ago. There were definitely times when I didn’t think I’d make it to here, which was worrying – I’ve not felt like that for a while now, but it has passed now really.

Over the past week I have felt a little on the edge. Motivation has been somewhat lacking and I feel exhausted and low, yet there has been a strange bouncier edge to it too at times. Things don’t feel stable any more. 2010 was a year of relative stability. During summer things were pretty consistent and I felt quite well. Since autumn I’ve been consistently low, but mild depression is manageable. Now I’m all over the place. A few days feeling better, a few days feeling rubbish, one day where I feel all over the place, another where I feel strangely mixed, the occasional day when I just feel normal. There is no consistency at all anymore.

My sleep in particular is a mess. I really struggle to get up each morning and feel exhausted, but then I spend the late evenings trying to slow down my racing and flighty thoughts. I can’t seem to concentrate on any one topic but spend the night with random things darting around my mind. Even when I do sleep, my dreams jump about and I wake up frequently, often shaking or panicky. My dreams have been so weird it has been disturbing me. I find myself thinking about them in the day or unable to shake the uneasy feeling that goes with the nastier ones. Occasionally suicidal thoughts pop up and sometimes these thoughts can be so clear and urgent it can be scary, but there are also excitable flighty thoughts – plans about holidays, knitting, work etc, which would suggest a good mood. It feels slightly strange and can be somewhat frustrating when I can’t sleep, but it is preferable to feeling how I did before Christmas. I quite like the flighty-awake feeling and if I didn’t need the sleep I’d happily become nocturnal and make the most of it, but my body is really tired and I don’t want to keep the bloke and the dog up, so instead I lie in bed tossing and turning.

The last couple of days haven’t been so bad on the mood, but I have been struggling with nausea on and off. I’ve not been sick, but on Sunday night I felt awful. Being sick would have probably been a relief. Nausea does tend to calm down the flighty side of things as moving about just makes me feel worse. Not feeling too bad at the moment, but it seems to come and go.

I am hoping the recent instability can be put down to fiddling with the Reboxetine dose and not taking it consistently at the same time, but I’m not so sure. Things were going haywire before I started the dose experiment. I was told to try taking 8mg some days and 6mg on others to see if it helped with the side effects. I tried it for a bit over Christmas but I found it made the side effects worse than normal on the day I took 8mg and I didn’t feel much respite when taking the lower dose. I’ve also been struggling to get up, so was taking it later than normal, which definitely contributes to the insomnia at the other end of the day. I was trying to take a lower dose on those days, but that didn’t seem to help too much. Things are noticeably worse though if I take the full 8mg dose after about 11am. I’ve gone back to the full dose though and am taking it earlier again, so I hope that will help settle things down.

I saw Dr M on Friday. I mentioned all of this to her. The rapid decline in December, the slight improvement over Christmas and the up-and-downy-ness since. She seemed slightly surprised and a little concerned when I indicated how bad I felt in December, but relieved things have improved a bit since. She thinks I’m a lot stronger these days and that I will be able to manage things better even if I do get more depressed. I think she is probably right.

We discussed medication again. She does think something needs to be added to the Reboxetine. If we can boost the effectiveness of the Reboxetine then maybe I could drop the dose and reduce the impact of the side effects. She’s concerned about sleep too and wants something that will help on that front at the same time. Quetiapine was encouraged again, but I’m still not keen on the idea. It didn’t do anything helpful for me before and I doubt it will again now.

The other option was Mirtazapine. I’m not sure about this either, mainly because of the weight gain risk. I’ve lost a lot of weight over the past year and the last thing I want is to put all of that back on. Aside from that it could probably be a good option. It is meant to be sedating and also partly works on Noradrenaline, which should help. It has a longer half-life than Reboxetine, which could also help stabilise things.  I haven’t tried it before so it may be worth a try, especially as it can work when other drugs haven’t, but I’m not sure. I don’t know if it is worth the risk of it not working, although I guess if the side effects are bad I can always discontinue it. I think I’d also be slightly annoyed if it did work because Dr N and I considered it right at the start, but decided against it because of the weight gain risk. Imagine if it is the right drug and we’d chosen it right back then – maybe none of the past 2 years would have happened. Glorious hindsight. I am not sure though and the bloke is definitely not keen on the idea. He thinks I should just try and manage as I am and do what I can to boost the Reboxetine over the winter. Maybe he is right, but then again I don’t want to experience a sudden drop again like in December as if that happens maybe I won’t be able to manage.

I didn’t want to rush into any sudden decision with Dr M anyway, so she said she’d write to Dr N, tell him what she suggests and leave it up to us to make the decision. He can prescribe it if I decide to give it a try. I need to book an appointment to see him and see what he thinks. I think he would be pretty keen to get me off the Reboxetine if we found an alternative that didn’t send me mad, but it’s a risk and I don’t know if it may be better to wait and see.

Friday was also a year since I tried to freeze myself to death whilst overdosing (it sounds ludicrous to me now) landing myself in hospital for 5 weeks. It was weird to see Dr M almost a year on from when we first met and I mentioned this to her. We both commented on how much better things are now. Quite a lot has changed since then and I do wonder if her initial impression of me has changed. I realise now that I was delusional and paranoid at the time we met, as well as being suicidally depressed, but it still upsets me that my behaviour was put down to a disordered personality and not simply the fact I was somewhat mood-disordered and dealing with the after effects of an overdose. I was definitely not myself and I don’t know how anyone could take that first meeting as representative of my usual personality. I am still frustrated by the whole thing and find myself pondering over it again and again. I wonder if now is the time to challenge the whole diagnosis malarkey and find out what she thinks now she has had much longer to get to know me. I wanted to bring it up and I keep considering it, but I’m just too scared. I am terrified of being told they still feel I have a PD. At least before there was always that bit of doubt and a hope they would realise they were wrong. If I bring it up then I may have to face the fact that diagnosis is going to follow me around.

I’m not sure if I ever wrote about this before, but one of the main reasons I want to challenge the diagnosis again has come from the appointment I had with the locum GP a few months ago. When I was there, he looked back through my notes to find something. We were both watching the screen and as he scrolled through I could see that “Personality Disorder – NOS” was filled in the diagnosis box, visible in big bold letters. On some of the entries it didn’t even list “Recurrent Depressive Disorder”, which is meant to be my main diagnosis. In fact it is meant to be my only diagnosis, because I had been told that they wouldn’t give a proper diagnosis of a Personality Disorder unless the psychologist from psychotherapy (when I eventually start it) thinks I warrant it. I had assumed all mention of the dreaded diagnosis would be dropped until then. Apparently not.

So yes, this has concerned me and since then I have toyed with the idea of applying for my notes. I want to see what has been written about me, especially about diagnosis. I have been somewhat paranoid since. I worry about being seen as just another PD and that any physical problems are seen in this light. I worry that Dr N thinks I’m making things up. It has definitely damaged my relationship with Dr N, as I worry that he just sees me through PD disordered lenses and I don’t feel I can trust him as much anymore since finding out he has been using the PD as my diagnosis. I have found it a lot harder to talk to him since then. I have thought about bringing it up since that appointment, but the time passed and I think I missed my chance.

Another opportunity to bring it up may come up soon though. On Saturday I finally got my new assessment appointment date for psychotherapy. It has been nearly 18 months since I was referred. I have an assessment tomorrow with a clinical psychologist, HP. I hope it is less pointless than the last one, but I have no idea what I can say to her. I am worried about bringing up the diagnosis thing. I may just see if it happens. I don’t know what we are going to talk about though. I have no idea what may help or what I need to discuss. In general things are okay and the things that were identified long ago are no longer relevant. It is the more physical sides of depression that get me most these days. I’ve waited so long that I have to see what they can offer though. Maybe it will help in the long term. It may at least help to have somewhere to discuss how I’m feeling about work as I’m trying to get back. I’ve felt a bit on my own in that regard. Fingers crossed it goes okay anyway.

The other thing that Dr M brought up at the end of our appointment, was this blog. She asked if I was still writing. I admitted that I was, although a lot less often than I used to. I said that I keep wanting to write, but don’t often find the time. I go through fits and starts. She seemed to find my response interesting and seemed intrigued. I wondered if she would get curious and want to look at the blog since. I suspect she may have, as someone in the area visited the blog the day after my appointment. I don’t know whereabouts she lives in the area and I guess it could be anyone, but somehow I got a feeling it was her. I’d like to know if she has read it or not though.

So yeah, that was that. I have a lot half-written about work and more to say, but I will leave that for another post. No idea when I will write it though.

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.

A long week…

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A lot has happened in the past week. I kept meaning to write, but time got away from me.

I saw Dr G last Tuesday and was disappointed. It was a fairly pointless appointment. I did mention my dip in mood in the weeks prior to seeing her, but she didn’t have much to say. She increased the Lamotrigine again by the minute amount of 25mg, so I’m now up to 125mg b.d. She asked me about the hand over to the NHS. She seems ready to hand me over and doesn’t seem to want me to continue seeing her once I’m in the hands of the NHS. She thinks it will complicate things, which it would, but I trust her a lot more than I trust the NHS and I appreciate the constant input. I’m worried about the frequency I will be seeing the NHS psychiatrist. Talking about this with my social worker today, she said that if people are “stable” they will only see the psychiatrist every 6 months, even if that stability isn’t a particularly nice state to be stable in. She said I may see them a little more often at first, but even then it may only be every 3 months or so. This terrifies me. At the moment I always have that “if I can get through the next fortnight until I see Dr G, things may be okay”. This can keep me going. Knowing I’m on my own for months may be enough to make me give up again. I know I can ask for a rapid access appointment if things get scary, bad, but I’m not sure that’s enough and I can’t be asking for one every month or so!

On Tuesday night I learnt the bad side of knowing lots of people with mental health issues. One of my friends who I met in The Priory texted me to thank me for being her friend and to apologise for the fact she was going to kill herself that evening. I didn’t know what to do as I felt powerless to intervene and hypocritical for wanting to do so. She had been a long-stay patient in hospital and I believe was on overnight leave at the time. In the end I contacted the hospital she had been at and told them what she’d said. They wouldn’t discuss it with me due to patient confidentiality or even acknowledge what I had said, but I hope it alerted them and was of some help. They told me to call the police instead as they would have the power to intervene, but I didn’t want to do that. She tried to call me a couple of times in the evening but I missed the calls and when I called her back she didn’t pick up. I was worried but I did what I could. I was relieved when she later texted to say she had been picked up by the police, although worried for her. The hospital she had been in have chucked her out, presumably for breaking the rules of her overnight leave. I’m shocked and appalled by this decision as she’s at her most vulnerable at the moment. The people who are meant to be caring for her have dumped her when she needs them most and she is now alone and extremely ill. Last I heard she was staying with some friends and I just hope they can keep her safe.

This whole thing was triggering for me. I wanted to help her and intervene with her decision, yet I myself wanted to do exactly what she was doing. I was jealous of her at the same time as worried for her. I was angry at myself for being so hypocritical. I knew that if I was in her position I’d have been frustrated if she had intervened, but then I still wanted to do something. I couldn’t just stand by and let a friend die. I was comforted by the fact that she had contacted me. It suggested to me that she wanted someone to do something. She’d have gone alone and quietly if she was completely determined to succeed.

Wednesday started with a trip to Dr N so he could steal my blood for the mood disorder research. He struggled to get anything out of me. Spent ages trying to find veins in my arms and used my wrists in the end. The first attempt failed and has left me with terrible bruising and some wrist pain. The second attempt was eventually successful, but painful as he pushed the needle around in my wrist. We got there though in the end.

After this it was a trip to my office. My work laptop was due to be upgraded so I had to go drop it in to the IT department. It was weird to be in my old work environment. It made me realise that I really missed it. I wish I could just go back and do my job.

I had Creative Remedies in the afternoon. It was visual arts this time, which boils down to painting. I was disappointed by the class as it is restrictive. We had to start with a “colour wheel”, which made me feel I was in primary school. I know very well which colours mix together and what primary and secondary colours are. For our first project we have to choose images from a selection of Japanese, Egyptian and Art-Deco pictures and use these as inspiration. It feels very much like art at school, which is frustrating as I’d rather paint whatever I liked. I was impressed with the materials on offer though. We get a portfolio folder and sketchbook, access to good quality acrylics, watercolours and gouache paints and canvasses to work on. It’s all free so I can’t really complain. The teacher does seem to be experienced and the outreach workers are the same as on Monday’s session, so we should be able to develop a good relationship with them. I’ve been getting on well with one of them in particular already. It is basically just an art class though and not art therapy at all and although it gets me out of the house and doing something it doesn’t seem therapeutic. I miss the emotional freedom of art therapy at The Priory and the therapists there.

Wednesday evening saw us heading over to Snowdonia for a few days camping. My parents and grandparents had rented a cottage over there for a week, so we joined them for a couple of days. It was nice to get away for a few days, but I was feeling a bit flat a lot of the time. A good campsite near Beddgelert, we enjoyed nice food at The Goat Hotel on Wednesday evening.

The highlight of Thursday was a trip to Harlech castle, but a further reminder of my illness. Disabled admission was one such reminder. A bonus in that it was free, but even still I feel weird asking for it. I find it hard to think of myself as disabled. The second reminder came from climbing the towers. I felt uncomfortable at those heights. I am not scared of heights in any way, but I wanted to jump. If my parents and partner weren’t with me it would have been a huge temptation. I don’t think I could do that in front of them though. The image of my fall would haunt them for too long. Aside from this though it was good. I’ve never been such a big fan of ruined castles, but the views were fantastic.

Friday brought beautiful weather and a trip to the beach. We struggled to find one where our dog was welcome, but eventually stumbled across a beautiful little cove, with golden sands and shallow water. The beach was almost deserted with just one other couple there most of the time. We went for a swim, which was of course cold, but good. It was lovely to see our puppy swimming properly for the first time. I felt like a proud parent. There were also lots of little silver fish swimming around, which was unusual but made me a little squeamish.

We came home on Saturday, amidst drizzle and murkiness. A real downer after the lovely day on Friday. Our tent was soggy and I hate packing at the best of times, so I felt pretty awful. I’ve just felt pretty low all weekend and have had little motivation to do anything. I just want to hibernate really.

The highlight of today was another trip to Creative Remedies. I have enjoyed it and I think I will continue to, but I am still unsure of the therapeutic benefit. I wonder whether the vast amount of money that is being spent on this should be put to better use elsewhere, especially in reducing the waiting lists for other therapy.

My social worker came over today to check up on me before we both go and see the NHS psychiatrist tomorrow. She had some paper work to read and sign – mainly my risk assessment and enhanced CPA. It was weird to read a catalogued list of risks and declarations of my suicidal thoughts. She asked me what I wanted from the appointment tomorrow and tried to set some expectations. It seems that we will go over history and recent mood. It is apparently unlikely that the psychiatrist will change my medication on the first meeting and it is likely that I won’t see them again for a while. I don’t see the point in just going over my history and not actually doing anything. He can find the history in my notes and I’d rather use this appointment to make some changes that may help me to recover. We will see though. Wish me luck. I really fear I am going to need it.

More Evidence…

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Some of you may remember my post on Trichotillomania which I made a couple of weeks ago. In it I referred to this BBC article which mentions some research into the use of N-acetylcysteine (NAC) for the treatment of Trich. Today I saw Dr G and towards the end of the appointment my bloke mentioned the article and I explained it to her. I couldn’t remember the name of the drug involved, so she asked me to check and let her know. She hadn’t heard the news story herself, but was interested to know more and was happy to check if it will interact with any of my other drugs before I can give it a go. Dr G is quite progressive and innovative with what she prescribes anyway. She won’t always wait for things to become proven and approved before she prescribes something. She also mentioned a new drug, for which I could spot a leaflet about on her desk, that is meant to be good for sleep, but it’s also an antidepressant and she’s scared of the effect this may have being bipolar and my past experience of antidepressants. She said research is currently being done, but this one she didn’t want to risk.

Anyway, whilst I was looking up the name of the drug concerned in this article, I did a little bit of research and stumbled over the fact it had also been connected to improving residual depression in bipolar. Someone has done a some research into this and the paper was published last September. This article sums up the findings. If this really is the case, then there are two reasons for me to be taking it. I am certainly willing to give it a go. It’s a proven drug for other things, so should be safe and even if it isn’t, do I really care? Maybe that is flippant of me and my partner will be horrified to read it, but I really don’t worry about such things anymore. I guess that is the suicidal thinking that undermines everything. I should be thinking about this positively though and my willingness to try anything is the part of me that just wants to get better and doesn’t care how I do it.

For a change, Dr G was running on time. My therapist, M however wasn’t. With that in mind, we got started and did a quick meds review initially. The expected increase in Lamotrigine happened and an increase in the Nitrazepam too. I could do this prescribing lark myself these days! In two weeks time we shall do the increase again and I will then be on the 200mg she’s aiming for.

We talked about how things over the past few weeks seem to be showing signs of stabilisation and improvement. This is true but I say it with caution. In the past three weeks I’ve gone from rapid cycling every day or two between an almost okay mood and a horrifically suicidal one. This was followed by a week of consistant suicidal depression and generally feeling awful. Then over the last couple of days I’ve kinda felt depressed but getting closer to okay mood. The suicidal thoughts are still there, they never go away, but things are quieter.

The thing is, I don’t trust the cycles to not come back. My mood sometimes settles down and then the swings come back with avengence and I am up and down like a yo-yo again.  I also don’t trust the curve on the mood graph to continue rising. It has only been a couple of days of slightly improved mood and I’ve had that before. The bubble bursts as quickly as it forms.

Dr G is hoping that things are stabilising. Last week was stable but hell. If things stick like that it just isn’t going to work. I will get frustrated and then fall off a cliff, which is similar to what happened last January/February. She knows this and I think is as worried about it as I am, but I guess neither of us knows what to do about it. We just have to try and hope that this mood holds out.

M turned up and we talked a bit about what we’d said last week. Dr G was meant to have another appointment with the four of us there last week; Her, M, my bloke and me. At least that’s what three of us thought. Dr G was at her daughter’s graduation and had somehow double booked herself. The three of us carried on and had a session anyway talking about some of the relationship issues we’ve been having and communication. It is a topic that always comes up but an issue that doesn’t go away. Again the solution seemed to be to wait a few months and try not to think about it. Easier said, but they aren’t living with the torment all the time.

The rest of the appointment consisted of lots of ums and ahs whilst I grappled for something I felt comfortable to talk about. I generally failed until the mention of that article came up.

The previous couple of days have been spent at my grandparents. I hadn’t seen them since March last year, when it was my great grandma’s funeral. It was good I guess to see them although always a bit surreal and slow. It always feels like a bit of an act at the best of times, but even more so at the moment. I also saw my two cousins on that side of the family. H, the youngest, loved our puppy. My animal-mad aunt did too for that matter.

The future holds very little at the moment. I don’t know what to do with myself and that is scary. I have a lot of uncertainties and I want answers. I see my worker on Monday and Dr G in a couple of weeks. Aside from that, who knows?