Into the system…

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Posts Tagged ‘stigma

Phased Return…

with 29 comments

So last week, I finally met up with the HR manager to discuss Dr Occy Health’s latest report and we have agreed that I can begin a very slow phased return.

I am starting with 2 hours a week on Tuesdays and Thursdays. I will be doing this for the next few weeks until I see Dr Occy Health again in December, when we will review again. All being well we will add a few more hours to each day and eventually extra days until I am back full-time, but I have been told to expect this process to take many months. I have no idea if I will be able to cope with going back at all, but it is time to try. It has to be a case of seeing how it goes and hoping that the transition is smooth.

It’s more than two weeks since I saw Dr Occy Health and our discussion about how I may go about a return to work. He seemed reluctant to try and push me into anything more than I was already doing (the occasional short visit), but I asked about formalising something more and he agreed I could begin with a slow phased return. He set some guidelines, but said I would need to arrange the details with HR, rather than him prescribe anything more definite.

The guidelines suggested that I am restricted to a maximum of 15% of normal hours at first. I didn’t ask him if he meant contractual hours or realistic ones, but I suspect he meant the former. It would mean quite a big difference – my contractual working week was 37.5 hours, but realistically I did anything upwards of 50 hours. I don’t think I will be allowed to do those sort of hours again though. Essentially I am restricted to a maximum of 5 and a half hours, which I guess seems reasonable, although of course I am only doing 4 at first. I don’t know how long this restriction is meant to last – the first week, first fortnight, first month? It looks like it will be at least the first month though and possibly even until the new year.

He suggested I start my working day during late morning, which suits me fine. I am usually at my most stable in the middle of the day and I am not used to early starts any more, so it makes sense for me to try and work when my mood is best. It also gives me the chance to take the dog out and get anything else that needs to be done beforehand.

Whereas over the summer my mood was consistently on the low end of normal and hardly ever changed, since the slow decline in my mood during late September and the subsequent increase in Reboxetine, my mood has been fluctuating a lot more. I am having good days and bad days, rather than lots of okayish ones and my mood is varying during the day too. Over the past month, my mood has been largely following the classic depressive cycle of feeling worst in the morning and mood improving throughout the day. I am waking up feeling pretty depressed each morning, but by lunchtime I am usually feeling okay. By evening, I am often feeling agitated or edgy, which is also not conducive to work either, so not leaving work until too late in the day is probably wise. Occasionally I’ve had a day that has gone the other way around or the morning depression has lingered long past lunchtime, some days are just crap all round, other days are absolutely fine. On the whole, I think the increase in Reboxetine has brought my average mood up again, but I am less comfortable with the instability that has come with it. I don’t know how I am going to feel from one day to the next and I find it harder to plan what I’m going to do, because one day I will be able to get loads done and the next I can’t face getting up. My mood isn’t really getting to the extremes, but it’s wobbly enough to be problematic.

Alongside the fluctuating mood, is also a fluctuating, but omnipresent level of anxiety. Most of the time I don’t even know what I’m anxious about, but I just feel the physical presence of anxiety lurking in my chest and a niggling worry about something in my brain. Sometimes that physical presence is a lot more than just a niggle and I feel physically sick, my heart keeps skipping a bit and I feel dizzy and shaky. I am getting a lot of nightmares too. Often I don’t know why this is happening. Sometimes the cause makes itself very clear and I can’t stop thinking about it no matter how much I try. There are plenty of worries about work, how it affects my benefits and finances, my tummy troubles, medication, diagnosis stuff and other stupid things like “what am I going to knit next?” floating around, but they shouldn’t be enough to prompt the level of panic I’ve been experiencing.

I don’t really know where this anxiety is all coming from, because until fairly recently I’ve not had much of a problem with it. I am usually pretty good at managing my worries and very rarely have I experienced the physical symptoms of them. Anxiety was always tagged alongside my list of diagnoses and I was often sent to “Anxiety Management” at The Priory, but I think that mainly came out of an assumption that all depression comes with anxiety and not because I actually experienced it. I can use those anxiety management skills and rationalise my worries and thoughts, but I don’t seem to be able to beat away the physical results. I have been taking Propranolol for months and that is supposedly meant to reduce agitation and anxiety, but I don’t know if it does much good. Reboxetine is known to increase anxiety, so it could just be that, but I am loathe to attribute everything to the damn drug.

Anyway, we shall see how I go with my working hours. I think if I stick to the middle of the day I will be okay. I don’t think there is anything stopping me going in a bit earlier or later if I want so if needs be I can do that, but I think it’s important I try and stick to a routine and get used to going to work at a specific time. I don’t know what will happen when I need to increase my hours or which end of the day it would be better to add to, but we will come to that when it happens. Having a routine and going in at regular times is one of the things I am going to need to adjust to. I’m not sure I’m up to doing stuff whenever I have to, rather than just when I feel up to it. When I’ve had chores I really need to do and am having a bad day it can make things a whole lot worse, so I hope I can manage.

Another guideline suggested that whatever I do is non-client facing. This is pretty important to me at the moment, because I can’t deal with the stress and responsibility that goes with working directly for the client. I am having to remember how to communicate in the world of business and not the world of mental health services or just with my friends. I think it is going to take some getting used to. I don’t know what to write in work-related emails or how to talk to people any more, so I’d rather keep my communication with others down to a minimum until I get used to it. At least if I make an idiot of myself with a colleague it’s not going to get me fired, but say or do something stupid with a client and I could be in trouble.

This is actually something that upset me during the HR meeting. The HR manager said she was worried about how I am going to cope interacting with others in the workplace. She remarked that observing me at the community meeting I went to the other week, she was worried that I was too honest and open with people and she is worried that my openness will shock people. She said she doesn’t want me to stand out too much or give people the wrong impression. I don’t think I said anything other than that I’d been off work for a couple of years due to illness, but I am currently in the process of returning to work. I didn’t elaborate on what kind of illness I’d experienced. I only said that because we were asked when we joined the company and what client we were working with at the start of the meeting. If I didn’t explain that I’d been off for a while, it would look like I’d been passed over for promotion a couple of times and that I wasn’t chargeable to a project, which I think would have been more embarrassing.

I’m not ashamed of the fact I’ve been ill and don’t see why I should hide it from people. I didn’t mention mental illness, but even if I did, it shouldn’t be a problem. I’m sure nobody would be telling me not to tell people that I’d been off work if it had been cancer or a heart attack keeping me away, so why do I have to hide it because I’ve been off for mental illness? I don’t intend on telling everyone the whys and wherefores, but questions are going to be asked or assumptions made unless I say something. You can’t just ignore two years of my career that have just disappeared. The gap in my company CV and in my client history is plain for everyone to see and the fact I’m still at my current level over 3 years after joining, also points to some kind of problem. I don’t see what is wrong about being honest about the fact I’ve been on long-term sick leave. I don’t know what else I’m meant to say. I have no intentions of lying or deliberately hiding the truth.

She said I should treat it like starting a new job and I should remember that I will be meeting new people all the time and they don’t know my history, so I should feel no reason to tell them. I understand this and agree, but the problem is that there will be plenty of times that my absence will be obvious. My company start date and level is on my people profile and my CV is on the system for anyone to see. The question of what client I am working on or have worked on in the past is going to come up. People I have worked with in the past will see me and ask where I’ve been. People will see me arriving and leaving the office at strange times, only working for a few hours and doing pointless tasks. I can’t hide things forever and I see no reason why I should, especially as I don’t have to worry about HR finding out, resulting in me losing my job. HR know the whole grizzly story, so there is no reason to hide. I will have to be honest with whoever I work with next, because I will be working reduced hours.

I was really quite upset by this comment and it took a lot to bite back the tears that were threatening. I knew I couldn’t break down at that point, because she would never think me well enough if that happened. I really would look like an overly emotional mental person if I burst into tears in her office and it would confirm all of her worst fears, so I did my best to maintain my composure. She thinks that I’m not able to act professionally and deal with people’s reactions and of course her comments do feed my own fears and anxiety. I am scared about what I will say, but I have thought about it a lot and see no option but to be honest. If they aren’t happy with that, then it is their problem, not mine. I know I am going to have to get used to this kind of thing, but it hit a nerve. I worry I will be faced with this dilemma for the rest of my life.

I’d asked Dr Occy Health if he thought I should or could go to the all-day community event and Christmas party in London. I’d like to go because I have missed out on the last couple of years and the meetings are usually interesting. I think it would be a good opportunity to find out what is happening in the company at the moment and the party should be fun too! I was a bit worried about the fact I will be travelling down to London on my own and it may be a bit much, but I think I will be okay. Dr Occy Health agreed that it would probably be good for me and said he would put a comment supporting my attendance on his report.

HR Manager was less keen on the idea. She was worried about me travelling to London on my own and is worried that I won’t cope with meeting everyone. She seemed worried about how it will look if I manage to attend a whole day event and a party, yet I’m only able to work four hours a week normally. People may judge me for it. They may, but it is a bit different spending a day listening to someone else talk than actually having to do proper work and very few of them will know I’m working reduced hours anyway. We have agreed to take a call on it next week, so we shall see what she says. I don’t know what is the right decision, but I’d like to go if I can.

I can’t remember what the other guidelines said. I think they probably mentioned local working and having a local manager, but I’m not sure. There was a note about me being protected by the DDA and the fact that these could be considered “reasonable adjustments”. Finally it was noted that I should be reviewed by Dr Occy Health in early December.

I hope I can manage. I have survived my visits so far, but I think it will get harder when I have to tackle some proper work. I have run out of initial tasks now, but HR Manager talked about the possibility of me doing some work for her. There’s a project she is considering that is related to something I did on a previous role, so I may be able to help with that, but I don’t know yet. I’m just waiting to see what she suggests.

At the moment it is a bit frustrating. I feel weird when I arrive at work so late and have to leave so early. I worry what everyone thinks of me. I generally feel okay whilst I am working, but I struggle either side of it. Strangely, one of the weirdest things is wearing smart clothes again. I am not used to it.

I wish I could fast forward to being back properly, but sadly that is not an option. I have been off work for nearly two and a half years though and I know it is going to take a lot of adjusting to go back. Dr Occy Health keeps reminding me of this and I think as far as he’s concerned, it’s a miracle that I’m trying to go back at all. This is somewhat disheartening, but I know the statistics and he must see enough people that never make it. I hope I can be one of the lucky few.

Anyway, I must stop writing now. I always finish blog posts like this, but I never get the chance to say everything that I am thinking at once. I have been writing this on and off for days anyway, so it’s time I posted.

Written by intothesystem

Tuesday, 16th November 2010 at 6:35 pm

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.

Stream of Conciousness…

with 10 comments

I started this post on Monday, but didn’t get time to finish it. It’s now Sunday! I don’t know where my weeks are going. I keep snatching five, ten minutes or so to write, but it takes me half that time to work out where I was before. I keep wishing I could write more, but other things get in the way. I guess more accurately I could say another person gets in the way. My bloke is still not too keen on me spending time on here and that means I usually have to fit it in when he’s not around.

At Creative Remedies on Monday we were asked to write. To write and to keep writing whatever came into our heads for three minutes. I wrote something private, something which I had thought about writing on here for a while. My thoughts were about how I come across at Creative Remedies. I behave like I used to at work and at uni. Friendly, helpful, bright, but hiding how I actually feel. There is a front there that hides the illness. An act. I feel like I have two halves. One outgoing and intelligent, the other ill and flawed. One bright, one dark.

I soon wished I hadn’t have written this. The next step of the exercise was to place our work in a pile on the table. Each one would be passed onto someone else who would then highlight the bits they most liked. The idea was to give us suggestions of how we could turn our stream of conciousness into something a little more creative. I didn’t want to share these inner thoughts. I didn’t want to let anyone in and break down the front. It was made even worse because my notebook is distinctive so whoever got it would know it was mine.

I felt almost sick as I handed over my book. I was given someone else’s piece. Theirs was fairly personal too, but completely anonymous and it gave me no real idea of the context. It didn’t let me in like mine would let someone else in. I was jealous of the guarded nature of their writing.

I could see who had mine. They were writing fervently on my piece. I worried about what they thought. They hesitated to pass it back still writing away. She glanced over at me and mouthed the words “is this yours?”. I had to reluctantly nod as she brought it over to me. Everyone else was scrabbling away at the pile trying to find their own.

I looked at her words. They were kind and expressive, but I still felt a little violated. She had liked my writing, yet I still felt uneasy. She was worried for me. She could feel the sadness and emotion in my words and wanted to comfort me. She later asked me if I was okay. It felt strange and I wasn’t comfortable with her concern. I don’t know that I deserve it.

I know she will never see me in the same light. She is the one person that knows the façade isn’t real. She will look at me with suspicion wondering what is behind the act. Wondering how I really am. I feel like I’ve been found out.

It’s weird how I can write here, knowing anyone could read this, yet I am so uncomfortable. It’s weird how I’m actually considering dropping my anonymity on this blog, yet I didn’t want to drop the act with one person. How would I feel if the same person came along and read all of this? I don’t know.

I don’t know how I really feel about these two sides. I guess in some ways the act shows I am making progress. I can hold myself together in front of people now. I can portray a sense of capability and confidence.  I can actually do things and at times I even enjoy them. There have been times in the past year or so when there was no way I could hide anything and enjoyment was a foreign concept. I was a mess, unwell and visibly so. That’s not true any more.

Yet, I am not sure it’s a good thing. I wasn’t well a year ago when I was first admitted to The Priory and I behaved the same in therapy. I was the sensible, level headed, friendly one. I spent more time giving others advice than I did talking about myself. I was the helpful, confident person. People even wondered why I was there. I seemed fine. I wasn’t.

I don’t really like the act. I don’t like its return. I have worked so hard in therapy to break it down. To be more open and honest about how I feel. To be more true to myself. For the therapists at The Priory, I was making progress when I started to talk about myself. I was chastised when I went into helpful, clever mode. I wonder if I should chastise myself when I act like this now.

At times I wonder if the act was what broke me in the first place. The act was a problem before, back when I was at work. I kept going, working harder and harder to hide how I felt. At times fuelled by unidentified hypomania, at other times fuelled by denied depression. I didn’t want to admit I couldn’t cope. I didn’t want to fail. I wanted to be confident and capable and not at mercy of emotions or illness. I drove myself into the ground until I snapped and my world fell apart.

I am worried I will do that again. I have been doing new things and taking on new projects over the past few weeks. I have ideas, I want to do things, I want to be successful. It’s a familiar feeling. My life has been full of periods where I take on new things and projects, but more often than not I take on too much and cannot cope. With hindsight some of these periods can be clearly attributed to hypomania, but others I am less sure. I wonder if it is just my personality. I don’t want to immediately see everything as something to be pathologised, yet I also want to learn from the past. I need to recognise the patterns and change them. I don’t want to keep crashing head first.

I don’t know what my mood is doing at the moment. People ask me how I am and I don’t know how to answer. I’m depressed, yet am I? Yes, the signs of depression are there. I feel numb, empty, suicidal. Negative thoughts, anxiety, paranoia too. The physical signs are out as well. Headaches, insomnia, tiredness. It all points to depression, but it’s not the whole picture. I am excited about new projects, interested in things (albeit not everything), doing stuff. Where is the anhedonia? I don’t think it’s a mixed state either though. Not in a classic way. I am not really sleeping, but I am tired with it. My thoughts race, but no more than is really usual for me. I am a little on the snappy, agitated, quick-to-anger side, but not physically agitated or excessively so. I don’t feel like things are going too fast. yet. I wish my mind would make it’s mind up. I feel almost lost within my mood.

Going back to the topic of anonymity and this blog. I don’t really want to be anonymous any more. I am not ashamed of my illness and I think it’s so important people are open and honest about these things. We can’t break down stigma if we’re too afraid to talk openly about mental health.

I am not even worried about employers googling me. I have no intention to leave my company any time soon. Even if I was looking for a new job, if a company didn’t want to employ me after reading this then I wouldn’t want to work for them anyway. This may limit my career in future, but it’s something I’m willing to take the risk on.

There is a problem though and it’s my family. I am not sure I am willing for them to know how I really feel. I don’t want them to worry. I know my partner reads this already, but with my parents I am even more economical with the truth. I have never been open with them and I’m not sure I’m ready to start. I guess it is doubtful they will ever google me and find this anyway, but it is still a risk.

I realised though recently it’s not even that which is the main problem. It’s actually the stuff about my sexuality I’m most scared about. I thought I was comfortable with it. I thought I’d worked through everything a few years ago when I really went through a crisis of identity. I haven’t. I am fine with coming out knowing the people I am talking to are open minded, but I am not so sure about the rest of the world. More specific I’m not so sure about those closer to me. It doesn’t hurt if some stranger says something horrible, but if it’s someone I know it’s different. I know my mother can be quite homophobic and I suspect her opinions on bisexuality are even worse. I don’t want her to find out. I have always said that she doesn’t need to know and what she doesn’t know won’t hurt her. I suspect other members of my family would be even worse. I just don’t think I can face it.

I realised the other day that I’m not as comfortable as I’d like with my sexuality in general. The other night I was at the pub with a friend and somehow we ended up talking about gay couples. I mentioned a girl I know who used to be in a gay couple and she now goes out with a bloke. She made some comment about him “turning her” and I pointed out that she could be bisexual. She seemed a little taken aback by that and I didn’t know what to say really. It could have been the time to be honest myself, yet I was uneasy with her reaction. I wish I was comfortable enough to be completely “out”, but I guess I’m still not there.

I guess I could always go back and censor myself. I could make any mention of my sexuality private and I’d be safe, yet I don’t want to. I guess I could throw caution to the wind, face my fears and all of that, but I’m not sure I can do. I don’t know what to do.

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?

Anger…

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This is something I’m really ashamed about. Over the past few weeks I’ve been agitated and struggling to manage my anger. Worse still, I’ve often resorted to violence. I have been afraid to admit that there is a problem. I don’t want to reinforce stigma. I am afraid of reinforcing the prejudice that mentally ill people are dangerous and violent.

Over the past month or so things have become more problematic. I have found myself getting angry and agitated, often for no real reason. Things seem to happen very quickly and there doesn’t need to be a trigger. Sometimes I just seem to be agitated and aggressive and I’ve been taking it out on the bloke, both verbally, and more recently, physically, mainly punching, kicking or throwing things. Sometimes I guess I could probably be compared to a toddler throwing a wobbler! I pretty much lose all insight and the smallest thing makes things worse.

Normally, I wouldn’t say I’m someone with a temper. I tend to be pretty calm and argue my point constructively. Although I can get frustrated and agitated at times, I am usually able to contain things and don’t lash out.

In the past I have snapped and thrown things during periods of depression and agitation, but I’ve never directed it at any thing other than myself or the wall. Unfortunately that has changed recently and I’ve started to lash out.

A week past Sunday there was an incident when we were out walking the dog. I’d asked my bloke to do something and he’d ignored me. I asked him why he had ignored me and he said it was because he thought what I wanted him to do was stupid. I argued with him and ended up throwing a stone at him. It was an impulsive action and I didn’t really expect to hit or hurt him. He ducked and it missed, but then he picked it up and threw it back at me hitting me on the head. I made no attempt to avoid the stone. It was almost as if I wanted him to hurt me and I felt I deserved it. It really hurt, leaving me crying hysterically, although I think I was more upset about losing control than I was about the pain.

Last Monday there was another incident. Similar trigger in that I’d asked my bloke to do something and he didn’t, although this time I was even quicker to anger. He didn’t respond immediately so I threw the pair of trainers I was carrying at him. He snapped and hit me back, but I didn’t seem to care that I was being hurt.

I know that my bloke will probably fight back if I hit him, but I don’t care., although often I don’t realise I’m doing anything until I get hurt. There are times though when I’ve punched my partner and he’s threatened to punch me back and I’ve continued even though I know it will eventually hurt. I seem to almost seek the pain. Perhaps it is some weird form of self-harm.

Sometimes these outbursts can be triggered. My bloke does have a habit of purposefully trying to wind me up and taking the piss out of me. I used to just ignore him or get annoyed but not lash out, but lately I’ve been unable to handle this. I just have no tolerance for unfunny “jokes”.

There seems to be this constant underlying irritability and it doesn’t take much to provoke it. I am getting agitated at the smallest things. I just feel so wound up and unable to relax or contain it.

I am worried that things are getting worse. Before, I was getting angry and irritable, but I wasn’t violent. I have threatened violence in the past, but never actually tried to hurt someone. Recently though I’ve even threatened to strangle or stab my partner. I know it’s not right, but at the time I really do want to. I’ve managed to resist and he is also pretty good at restraining me (he is far stronger than I am), but I’m scared that something bad will happen. I don’t trust myself. I never thought I’d throw a stone at someone and I have, so what is to say I won’t just throw a knife across the room if I’m using one and someone upsets me.

I did think that perhaps the Nitrazepam was to blame. After all, one of the worst episodes was the trip to The Peak District after the dose was increased. When I explained what happened here, I didn’t really mention the fact I was quite aggressive. I was too ashamed to admit it.

I admitted things to Dr G last Thursday and she seemed to be pretty concerned. I wrote her a long note as I didn’t think I could explain things face-to-face due to the shame. She wanted me to talk to her rather than use the note, but I found the note easier. I think she saw it as a bit of a backwards step as I’ve not had to write to her recently. We’ve come on a long way in terms of our relationship and I find it a lot easier to be open and honest with her than I used to.

Anyway, she expressed her concern and asked plenty of questions. She even went as far to say that she thinks this anger and violence is as dangerous as suicide. I guess risk of harming others is grounds for admission, just as much as risk of harming oneself.

She was worried that me and my bloke are making things worse for each other and that we are almost self-destructing. I think she is right.  She said that I just have to try and take myself away from the situation and calm myself down as much as possible. If I’m feeling agitated then I have to warn the bloke to stay away and not wind me up!

We have agreed that I should come off the Nitrazepam, although we are not convinced that is to blame. Dr G thinks that this agitation and aggression is a sign that the Bipolar Disorder is not controlled well enough yet. She increased my Lamotrigine again, but also said that we may have to reconsider adding Lithium as a top-up treatment.

We talked about sleep but she decided not to try anything else for now. She wants to see if the increased Lamotrigine helps my mood at all and doesn’t want any sleepers to interfere I guess. My sleep has been terrible both before and since I saw her. I am struggling to get any sleep before it is getting light each day.

She asked me to pop in to see her in a week as she wants to monitor things more closely again. I’m seeing her on Wednesday, so we shall see what happens then. I can barely afford more frequent appointments, but I understand her concern and think the support is probably more important than the money.

I now of course know when I’ll be seeing the NHS psychiatrist, so I guess I’ve got another 6 weeks of Dr G before someone else. I don’t know what is going to happen when I see Dr B. I was meant to stop seeing Dr G, but I don’t want to. I think I may consider continuing to see her privately, even though the CMHT aren’t happy with it. We shall see anyway.

Written by intothesystem

Monday, 10th August 2009 at 9:50 pm

Hometown Glory…

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So I returned home for the weekend. I’m always astonished at how little that place moves on. We went into town on Saturday and it’s still the same faces and same places. Since I left home four years ago, so little has changed. The only notable difference is that M&S Simply Food, Costa and Pizza Express have moved in, obviously trying to turn this little town into an identikit, affluent small town. No doubt more will follow. It’s the faces that get me though. The same people, living the same dull lives. I see people from my school and they seem so far left behind. They’ve not moved on. It’s weird.

I’m not sure the title of hometown glory is quite right. Perhaps, hometown misery would be more accurate. Of course the title really comes from the Adele song of that name. It’s a song I definitely associate with this episode, the episode that continues a pace. It doesn’t lift my mood, only stands to fuel it, but I’ve never been one to turn to happy bouncy music to cheer myself up. It doesn’t work and only makes me irritated. Before I was off work, I listened to it on repeat during my commute, turning the volume up and shutting out the world, driving too fast and not caring if I make it. I know how irresponsible that is and I’d hate for anyone to get hurt, but I just hoped it would be only me.

I have to drive those roads today and I know it will be a risk. It is always a risk. I don’t care enough about my life to be careful. My car needs servicing and the garage is next to my work, so I will drive those roads again. Since I was off work, new signs have gone up. They say 4 deaths in 3 years or 79 casualties in 3 years or 46 collisions in 3 years. I know they are designed to make you think and slow down, but every time I see them, they only serve to make me wish I could add myself to those statistics. An “accident” would be easier. It wouldn’t hurt my family as much. Of course they would be upset, but they wouldn’t have to live with the knowledge that I’d killed myself. The knowledge that I was so selfish and careless that I didn’t think of them.

I made it through the weekend.

I got drunk on Saturday night in an attempt to make it easier to pretend. It was a strange evening. I was giddy and hyper, playing the games and singing along to the music, yet given a moment to my real thoughts I was full of sadness. Alone in the bathroom, I hurt myself for the first time in a while. Just superficial scratches with a sharp pin I saw lying around, but I musn’t have been feeling things as I have lasting marks. The reason I used to scratch was to give short sharp pain, quickly but leaving only feint marks that would fade. I must have done it harder than before, as the marks still haven’t faded and I can still feel them. I see them now and want to do more, but I need to be able to hide. No one has noticed the scratches yet. I hope it stays that way.

Throughout the weekend, there was a lot of talking about friends and people from school. X is in australia, Y is just finishing medicine at Cardiff, Z is in London on the west end. It’s a small town so everyone wants to know everyone. You get the idea. I think part of this came from seeing my music teacher and choir director on Last Choir Standing and from Nicole Cooke winning her gold medal. Nicole’s father was my A Level physics teacher. It was a weekend of thinking about people and how they have moved on, how they have been left behind or how they’ve left me behind.

The one that shocked me though, the one that has had the lasting effect, was something my mother said. Talking about an old school colleague of mine, my mum jumps in with “the one that has really fallen off the rails is her brother, J. He’s a manic depressive. Really bad. I bet his sister spends all of her time trying to stop him killing himself”. This shook me. I hadn’t known he was ill and I was horrified to hear the way my mother referred to him. It was like he’d become a criminal, not mentally ill. I hated her for it. I am worried about him. I’ve tried to look him up on facebook, tried to find out if what she said is true. There are signs of it on her sister’s wall in his comments (trying to reassure her he’s okay), but I can’t view his profile, so I don’t know. I hope he is okay.

Of course, the other effect of this outburst is one on me and my relationship with my parents. My family do not know I’ve been ill. They ask about work and I have to be economical with the truth. I talk about it passively, saying that there’s a lot on, but not mentioning the fact I’m not doing it. I hate that I can’t be honest with them, but I don’t know what else to do. I don’t know if I could ever tell them. Knowing my mother’s prejudice makes it impossible. I know she doesn’t understand and she’s just ignorant, but I’m not sure I want to try and convince her otherwise. I wish I could talk to my dad, but I don’t want to hurt him and I think if he knew how I felt, knew my longing for death, he’d be heartbroken. I love my dad. We’re close and I hate lying to him, but I can’t handle the thought of my mother knowing. I hate the fact I can’t promise him I’d never do anything stupid. I hate how I resent my love for him, because I know it makes it harder for me to give into my thoughts and just makes this a never ending battle, in which I feel I can never win. It’s a relationship I struggle with and this secrecy makes it harder, yet easier too. I don’t know if things will ever change. I worry that they only will only find out if I’m ever hospitalised or kill myself and I’m not sure I’d be able to explain, but then I think that might just be the easiest way. I have this fear of hospitalisation, because I know that I couldn’t hide things from them if that ever happened. It builds this fear of honesty, fear of medical professionals and fear of the unknown.

I am struggling with nausea and have to get ready now. The physical effects of this are getting me down too. I haven’t been sick yet, but came closest this morning. I worry I might actually vomit though if I get in the car. I have no choice though. I’ve booked this appointment and I hate to cancel. I will find the energy some how.

work, work, work: but not at work…

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So I’m at it again.. writing more about work (previous posts here and here), but this time from the perspective of not being there.

Being signed-off is a weird experience. It’s difficult to know that everything you had been focussing on, everything you’ve been involved with, is still carrying on without you. Read the rest of this entry »

Written by intothesystem

Wednesday, 16th July 2008 at 1:10 pm