Into the system…

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Posts Tagged ‘suicidal thoughts

Home Alone…

with 18 comments

Time keeps passing. I don’t know where it goes to.

This weekend has been somewhat strange. The bloke is away for the weekend at a stag do and I’m home with just the doggy for company. I don’t remember the last time I was here on my own overnight, let alone for a whole weekend, so I don’t really know what to do with myself. Aside from my trip in the summer, there have been so few times when I’ve been without the bloke for more than a day since we went to uni. I was “well” in the summer too and now things are not so easy. I am managing, but it has made me realise how used I am to having him around and how much his presence keeps me functioning. Without him here, the temptation to give in and give up is so much greater.

Getting up and dressed is a struggle at the moment and I feel even less urge to conform when I don’t have reminders from the bloke. The guilt wears on me when he’s about and it serves to push me into action. It was only the desperate requests from the dog to be let out, that dragged me out of bed this morning. The thought of having to clean up any mess was enough to force me downstairs, but I climbed back in when she was sorted. I had to get up in the end as I was going over to a new friend’s for her kiddy’s 1st birthday party, but it took me literally hours to work myself up to that. Without that commitment today, the temptation would have been to stay in bed all weekend.

Food is another problem. The bloke is the cook in our house. I can bake cakes, but when it comes to a proper meal I don’t tend to bother. I don’t have the best appetite these days, but when food is presented to me I do tend to eat. Without the bloke around to cook for me, I don’t tend to bother. I’m even less inclined to cook at the moment as both our oven and the microwave are broken.

The dog is a commitment too and she does keep me going, but she isn’t as effective at nagging as the bloke is and I find the commitment straining. She did get me up this morning and she gets me into the kitchen, prompting me to eat at the same time that I feed her, but she is also tiring and I feel guilty when I just want to stay in bed and ignore her. She also got me to go outside for a walk, which I know is good for me, but at the same time I wish I didn’t have to. It’s so tempting not to bother, but I cannot deny her a walk for long or she turns into a great big bonkers thing, which is even more draining to live with than the walk.

I’m really tired. I want to sleep forever, yet sleeping for just a few hours seems to be enough of a challenge. It was late when I finally dragged myself upstairs to bed last night and I sat and knitted up there for a while because I couldn’t sleep.

Before the bloke left, I had to promise I’d be safe this weekend. He has been somewhat paranoid over the past few weeks that I’m suicidal again. The last two years have been particularly difficult at this time, in the run up to my birthday, so I know he is on edge. He doesn’t trust me at all and although I know his fears are not unfounded and it is only because he cares, it is still hard. One day last week I had nipped out and wasn’t home when he was due back from work. My mobile phone battery had died so he couldn’t get hold of me. I’d even left a note to say that I’d be back in a minute, because I worried that without my phone he would wonder where the hell I was, but he didn’t see it and just flew into a tailspin instead. He completely jumped to conclusions and panicked that I’d gone out to kill myself.

I’d actually nipped out to rescue the dog’s ball because she had lost it on our walk and I couldn’t get it out of the brambles and control her at the same time. She has a habit of diving head first into all the brambles and rose briers to rescue her ball then getting stuck – we both end up cut and bleeding, as I have to battle to rescue both her and the ball. I literally had to drag her home, shut her in the house and then go back out to dig out the ball from the bushes. By the time I got home I was greeted by the bloke just about to drive off in my car to try and find me, ranting and raving with anger. This isn’t the first time this has happened, but it the first time in a long while and I was disappointed that things had not moved on and that the trust hasn’t been rebuilt by now.

It turns out that he mainly panicked because he had been reading my mood log. I was updating one online and I had no idea he had been reading it. I tended to keep my notes in there very short and they were only for me, so a note mentioning suicidal planning thoughts did not necessarily mean what he thought it did. I was angry that he had invaded my privacy again, but I know it only comes from fear and concern. I don’t feel able to update the log any more though. It was meant to be for me and no one else. A reminder of how things are, because so often I cannot remember what my mood was like a week or a month ago.

But anyway. I agreed that I will be safe. I am safe, but it doesn’t mean the temptation isn’t there. My mood is low and I’d be lying if I said I didn’t think about it. This weekend would have been the perfect opportunity and there are times when I cannot help the thoughts, but I have resigned myself to sticking around for a while yet.

I know the fact it is winter and in the run up to my birthday can’t be helping. I have been in hospital at this time for the last two years, and both times I was desperately suicidal and determined not to be around for my birthday. This year I seem to have accepted that I will be around and although I am not overly happy about it, I’m resigned to it. I am low and I don’t really want to be alive, but I feel the obligation to be. Also, I’m not sure why, but being 25 seems like a much better idea than 24 anyway – something about round numbers I think. My worry is that I’m already having to battle the thoughts that 25 is a good age to die. I have no desire to see 26, even if I am sure I will see 25. I hope that my mood will pick up before those thoughts get too strong or that the approach of my 26th birthday gets too urgent.

As for my 25th birthday, as Seaneen will recall, my invite for a smear test arrived. I went and had it a couple weeks ago and it was fairly painless and straightforward, although I bled quite a bit afterwards. Unfortunately though I got a letter on Thursday saying the result was “inconclusive” so I have to go and have another one in three months. I think this was just a case of not enough cells, at least that’s what I’m hoping, but it’s still pretty annoying to have to wait before they do it again.

In other news, I’ve had a review form for DLA to fill in for a couple of weeks now and I’ve failed to do it. I wrote to them before Christmas at the same time I wrote to notify the DWP that I was starting work part-time for ESA purposes, to say there had been *some* improvement to my condition since my initial application for DLA. I felt I had to, as I have been receiving Higher Rate Care and I am not sure I should be getting that rate any more. They sent me out a review form and I started to complete it, but I made a complete mess. I filled in my surname in the first name section, my date of birth wrong and made mistakes all over the place, because I couldn’t concentrate enough to fill it in and my memory is so shoddy I kept forgetting things. After some frustration, I rang them to ask for another form because I had made so many mistakes. I got this replacement two weeks ago now and I have still not even started it. Thankfully because I requested the review rather than them, there is no deadline for me to get it back, but I know I need to do it. I can’t face it though. I can copy across the stuff that was correct on my first attempt, but I don’t know what to do about the rest of it. The form is overwhelming and I don’t know what to write, especially as my mood has been so unstable of late. Sometimes I look at the form, think nothing is wrong and answer everything as if I was fine, but other days I look at the form and realise I can’t do any of the things it asks, including filling in the form for that matter. I know you have to say how your good and bad days very and highlight what the worst case scenario is, but I just don’t know what to write. I don’t even know what to put in the diagnosis section. Should I have told them that my diagnosis is under question back when it was first questioned a year ago, or can I just tell them I don’t know any more? I guess the latter is the truth, I don’t know, but I’m not sure if I should have told them I don’t know. As far as DLA and ESA are concerned, I assume they think my diagnosis to be Bipolar II disorder, which is what it was when I applied. As I don’t know what it has been changed to, I guess I can’t tell them, but I worry about what Dr M or Dr N will write when asked. I hate having to evaluate how bad I am. I honestly don’t know.

Hmm I don’t know what else to write. There are things I keep thinking about to write, but I just don’t know what to say. It has been the same all week. For weeks really. I am meant to be keeping a diary for therapy again and I haven’t managed to write anything properly. I just don’t know what to say. Brain is mush. I cannot think, I can barely feel. I just want a new head.

I am feeling increasingly agitated this evening. I am not sure why. Maybe now is the time I stop and knit for a bit to see if it calms me down. I spent a lot of yesterday knitting – I made a hat for the little boy’s birthday today and started a frilly scarf and it kept me busy and distracted whilst I was on my own. It’s the first thing I’ve done for a while. I haven’t had the motivation or the concentration for a while. Sometimes I get the urge to knit and think of a million projects I could be doing and other days I cannot even comprehend lifting the needles. There has been a lot of the latter lately, yet yesterday my head was buzzing with ideas of things I could knit. I can only knit so much though and when my concentration is so crap lately as much as I want to make these magical creations, there’s no way I’m actually able to. I end up having to undo as much as I do.

hmm. Head is starting to spin. I’m both tired and agitated and feel like I may need to throw things soon if things get any worse. I don’t know why I am feeling like this. I have been good lately and I’m avoiding caffeine in the hope that would ease the occasional agitation, but it doesn’t seem to be helping. Maybe I should just go to bed and try to sleep or maybe I should have a bath. Perhaps I’m just grouchy and tired. I don’t know.

This is a bitty post. I don’t seem able to write properly at the moment. I started writing this about 4pm and it’s now 11.30pm. It’s not even very long. I have found it really hard to try and get things down or to concentrate on it. I have watched bits of TV and fed the animals and stuff in between, but the rest of the time I have just been staring at the box wondering what to put in it, or more likely how to slow down and speed up and unravel my thoughts to try and type them. Some of the time it feels like my brain is like treacle and the thoughts are just so slow and other times they are bouncing around and rattling off the sides and at the moment both is happening at the same time and it just feels like a big ball of mush. It all makes no sense.

Anyway I am going to stop and kick the dog outside. She’s already taken herself to bed, but she needs to go out or I’ll get woken up very early in the morning! I don’t intend on being up early. The bloke isn’t due back until at least mid-afternoon and I think I’m leaning towards a morning of hibernation.

8mg…

with 8 comments

I saw Dr M this morning. I’d not seen her for ages. It was back in July, just before I went to Europe (I haven’t written about my trip, but anyone following my twitter feed will know that I spent 2 and a half weeks InterRailing during July/August), so a lot has happened since then. She suggested that it was a good sign I hadn’t needed to see her sooner, but I indicated that it wasn’t especially. It probably would have been if I hadn’t have wanted to see her about a month ago. I couldn’t get an appointment then. This was the first Monday we could both do.

She asked about my trip. She was impressed and relieved that I managed on my own whilst I was away. It feels so long ago now, I didn’t really know what to say, other than that I coped, enjoyed most of it, but found it really exhausting.  I could have told her more, but didn’t see the point. There was limited time and plenty of other things to cover.

We talked about things with the bloke. Before I went away, things between us had been somewhat up in the air. When I last saw Dr M, there was a very real chance that we would split up. I haven’t written about this here before now, because I don’t think the bloke would be overly comfortable about me sharing this with the world.

The whole idea of the trip to Europe, was to give us some time apart to reassess things. I was going to just take a “boring” holiday somewhere, but options are limited for solo travellers and I’d always wanted to go InterRailing, so I decided to give it a go. It also seemed like a great chance to test myself to see if I could be more independent and to cope on my own.

I’d talked about all of this at my last appointment and Dr M was keen to know what has happened since then. Things between us have settled down and pretty much gone back to how they were before things became difficult. It’s almost as if nothing had happened. Neither me, nor Dr M could decide if this was a good thing or not. On the whole, it is probably good. Things were not good at all when I left and it is nice to know that he missed me a lot, but it has also been a little disappointing. When I got back, we talked a bit about what had happened and how we should try to improve things and appreciate each other more. Unfortunately, it doesn’t feel like anything has changed or improved.

We talked about my trip to Occy Health. I explained what he said about not starting a proper scheduled return yet, but how we tried to think about the ways we can solve some of the problems that are stopping me from getting back to work. I told her that he’d said I could try to visit the office and that I managed to go to a meeting last week for a couple of hours, which she was impressed by. It was a really big step, so that’s good. However, she seemed disappointed that there was nothing further planned yet. I suggested that I will probably try to go in again in the next week or so, but I hadn’t decided when yet. She wanted me to try to commit to a time and hoped that I could start to go in on a more regular basis, even if it is only once a week for a few weeks. She thinks that a routine and commitment to going to work on a specific day, would help me prepare for it better. I said that is actually what I’d hoped for, but that Dr Occy Health wasn’t sure and she seemed to accept this, but she thought it would probably be okay if I chose to do it, rather than having my work-place imposing it on me. She may be right and I was considering this myself. I will try and decide when would be best.

We did talk about my mood and how it has recently dropped quite a bit. I don’t think she was too concerned or especially surprised, although she was possibly a little disappointed. She asked about the usual stuff . Sleep, suicide, anxiety… She was not surprised to hear of my nightmares or generally rubbish sleep (occasionally too much or usually too little and never feeling rested). I had to admit that suicidal thoughts had returned, although they were a lot less frequent and different to how they were a year ago. She hadn’t actually realised that the thoughts had pretty much gone away over the summer, which was a surprise. I’m sure I’d told her last time that I wasn’t really suicidal any more and that I no longer felt that life was completely hopeless. Although I can feel pretty awful at the moment, I have got my hope back that I can be well again. A year ago, I could never imagine a life without feeling horrifically depressed, so it was no wonder I could see no future and wanted to end it. I do get frustrated at the fact that I have got worse again. I wonder if I will always be waiting for the next relapse and if so, is it worth it? I am able to cope with these thoughts at the moment, as I still have some hope of a recovery.

We talked about the risk that I may do something impulsive if I have a particularly bad day. I told her there was no immediate risk of me killing myself and that I have no intention to make any detailed long-term suicide plans like I have in the past, but that I couldn’t guarantee that I wouldn’t just do something on impulse. I don’t tend to be impulsive and have never made the decision that way in the past, but if an opportunity presented itself, there are times when I can be very tempted to take it. She recognised this and I guess she knows that there is always a greater risk of completed suicide when people are either recovering or deteriorating. When you are really, seriously depressed, it is far too much effort to kill yourself, but when you’re having a bad day after a series of not-so-bad days it can seem a lot worse and you are also more likely to have the energy and drive to do something about it.

I mentioned that I felt that the arrival of autumn did not seem to be helping and she agreed that there was probably a seasonal element. She had noticed back in the spring that things seemed to improve a lot faster for me when the weather picked up in April, so it is natural, I guess, that things would get worse again when the summer ended.

We talked about my medication and she agreed that it probably needs a tweak, if only to help me get through winter. Her first instinct was to add Quetiapine. Apparently, it was licensed the other day in the EU as an augmentation treatment for Major Depressive Disorder, although she admitted that most psychiatrists had been using that way for a while anyway. She asked if I’d been on it before and I confirmed that I had. I was taking it along with Venlafaxine, back in February 2009 when I overdosed on it. She asked what doses I’d been on and I said I couldn’t remember but I did get right up to 550mg. She said that for MDD they use a max dose of 300mg, but I had been on that sort of a dose for a while too, so I’m not sure it would help. I also mentioned that it never seemed to help with insomnia and that I had put on weight last time. She said she didn’t expect it to help the insomnia and she seemed genuinely surprised about the weight. Although it didn’t help me with insomnia, I know plenty of people who find it knocks them out, so that seems a little strange. There are also plenty of people that have found it made them put on weight too, so I am not alone. Both drowsiness and weight gain are listed in the common side effects, so you would have thought she was aware of that. Anyway, I said no to Quetiapine.

The other options were to do nothing, increase the Reboxetine, swap the Reboxetine or try to add something else. I wasn’t sure doing nothing was a good idea and we both agreed that stopping the Reboxetine was a really stupid idea, as it is the first AD that has ever helped me. Reboxetine has shown that Noradrenaline is probably the key to my wonky brain chemicals and there aren’t many others that help on that front, so we’re not sure what else to do. She didn’t have any bright ideas of anything else to try really. If not quetiapine, then she said we’d probably be looking at augmenting with Lithium or another anti-depressant, but she wasn’t sure what would be best. She said she would have a look for some ideas though before I next see her and she was welcome to any suggestions I may have – so if anyone has any ideas, let me know. I’ve been on most of the common combinations already and my only real thought is perhaps bupropion, but it’s not licensed as an AD here (although it is used an awful lot in the US), so I don’t know if she’d give it a go. I know a couple of people who have found it helpful though, so it may be worth a try.

In the end, we decided that increasing the Reboxetine was probably the best option for now, although I am worried about how I will be with the side-effects. It is worth a go though and if it is too much then we will have to try something else. I hope it helps, without making me feel too awful. She said she’d get a letter sent to Dr N. I have plenty left at the moment anyway, so will just increase the dose myself for now. It only comes in 4mg tablets anyway, so it makes little difference. So yes. I am now going to be taking 8mg of Reboxetine. I didn’t actually tell her that I’ve occasionally taken 8mg anyway, when I’ve not been able to cut one of the tablets in half to make the 6mg. One day doesn’t make much difference though, but 8mg over a week probably will. We will see anyway.

After that, I remembered that I had also been for the therapy assessment. I told her what had happened and that I will probably be waiting for someone to come back from maternity leave. She named the person she thought it would be. We shall see what happens anyway. She isn’t impressed that I’ve been waiting over a year and was shaking her head saying “it’s probably only going to get worse, only going to get worse…” as she looked at her diary to book our next appointment. It really isn’t good.

Anyway, time was up then and I had to go. I see her again in 6 weeks, so we shall see how we go with the Reboxetine.

Written by intothesystem

Monday, 11th October 2010 at 2:08 pm

Other things…

with 7 comments

Aside from the therapy assessment, there is a whole host of other things that I want to write about. I don’t really know where to start, but I’m going to have a go, because I think it may help me to get some of these thoughts down at last.

I need to start giving myself some more time. I’ve taken a twitter hiatus lately to try and free up some time, but it doesn’t seem to have made any difference. If I was spending an hour a day or whatever (probably more like 3 if I’m honest!) on twitter, I want to know why I don’t have an extra hour spare each day?

I am not sure if I prefer to have twitter in my life or not. Leaving twitter should at least reduce the number of arguments with the bloke – twitter is quite often the trigger for them, but whether or not it really has remains to be seen. He will probably just find something else to criticise. If he gets to win the argument on twitter, he will go back to trying to get me to completely stop blogging as well.

It should in theory give me more time to do other things, but I don’t think it has made much difference. It is very much true that whatever you have to do, will always expand itself to fill however much time you have to do it in. It is the same in that I haven’t worked for 2 years, yet I seem to have filled my time with other things. I don’t quite know how I would squeeze work back into my life, although I’d work out how to somehow I guess.

I do feel like I’ve lost something without twitter. It gave me two things. A feed of interesting information about the world in general and a more personal support group from the madosphere. I am missing both of these for different reasons.

The lack of general stuff leaves me feeling just a little bit behind. Twitter is great in that it can keep you up to date with things, real time. I have to go to more effort to find out things and to keep on top of the latest goings on. If a band that I follow releases tour dates, they will usually tweet about it. Now I have to wait until I spot them on some listings or on their website. If someone posts a news story about something I’m interested in, chances are I’d see a link to it on twitter pretty quickly. I am having to pay more attention on BBC News to spot things of interest. I guess I can do without this info, but when you are used to having it fed to you all the time, it is weird to go back to having to look for it. Twitter is certainly convenient. You can pretty much find anything on there if you wanted.

I am missing the support group side of things too. I feel that by stepping away I am neglecting people and I really don’t want to do that. I hope that people don’t take my hiatus to mean I am not interested in them or don’t care about them any more. It is not about that at all. I feel like I am letting people down by not being there all the time. Of course I miss receiving the support of my twitter friends too. It is nice to know that there is nearly always someone out there to talk to if you feel like it. It makes the world a little less lonely.

I do miss it, but a lot less than I thought I would to be honest. I can live without it, which maybe surprises me a little. It is convenient though

I don’t know if I will go back, stay away longer or perhaps just change how I use it. Maybe I will go private for a bit? I don’t know. If you are waiting for me to go back though, don’t hold your breath.

I didn’t start out with this post to write about my twitter hiatus, but there we go. It was something I wanted to explain on my twitter feed, but hardly possible with 140 characters. At least by saying it here, I can feel like I haven’t gone without explaining myself.

_______

So what else is there?

Physically, I am struggling. I have been suffering with persistent “tummy trouble” and irritable bowel issues lately. It has been there for months now. I was too embarrassed to say much at first (no one really wants to share their toilet habits do they?) and I thought it would improve, but it just got worse and worse and has been making things pretty rough. Constipation, diarrhoea, both, often with urgency, occasional vomiting, frequent nausea, awful tummy cramps that rival the worst period pain, chest tightness/pain, bloating and lack of appetite… None of which are particularly fun and when it all happens at once it makes you feel pretty awful.

Dr N and I are both pretty sure it is the Reboxetine to blame. I saw the locum last week as Dr N has been on holiday for a few weeks. He got me to have a collection of blood tests to see if there was anything else to explain things, but they didn’t bring anything up. I phoned up for the results on Tuesday and the receptionist reeled off a long list of the ones that were clear, but said I should come in to see the doctor about my liver results. I had a suspicion that this would happen, as it has done in the past. Apparently, one of my liver hormone levels is slightly higher than it should be, but it has been for some time and it is actually a little better than it was earlier this year. The other doctor probably wasn’t aware of this, so wanted me to see a doctor, but Dr N wasn’t worried about it. He did tell me that I should really keep any drinking to a minimum though, as my liver will struggle with any heavy drinking. I don’t tend to drink very often or very much anyway, so this isn’t so much of a worry, but it is a little concerning if I am going to be taking this medication in the long-term. Dr N thinks it will go back to normal if/when I stop taking the Reboxetine and joked that I can hit the booze then, whilst chastising himself for being a bad doctor for saying so. I don’t relish the thought that my liver results make me look like an alcoholic though. It is probably worth trying to be careful for the time being, I guess.

When I last saw Dr N about 6 weeks ago or something, he started me on alverine citrate as an antispasmodic, but so far it hasn’t helped all that much. I am having a few less of the sudden desperate trips to the loo, but still struggling with the pain and diarrhoea/constipation a lot. Today, he’s decided to double the dose, so fingers crossed it will have some impact. I am not sure I can carry on with these kind of problems for much longer. How anyone survives a life of IBS, I have no idea. Hopefully for me this will be temporary and I guess if it is caused by the Reboxetine there is always the option of stopping the meds, but I am not sure I like that idea.

The only good thing about all of this is that I have lost quite a bit of weight. Although that possibly isn’t such a good sign for my health. I put on a stupid amount of weight at the start of this year. Considering I wasn’t eating that much because the food was disgusting, I think I put on about a stone whilst I was in hospital in January and that continued when I came out. I don’t actually know heavy I got, because I stopped getting on the scales when it went over a certain number. I have pretty much always been overweight, although it probably bothers me a lot less than it should do considering my weight is not good for my health. However, over the last 6 months my appetite has disappeared and the weight has been falling off, without much effort at all. I have been more active over the summer, especially when I was travelling, but I think the loss of appetite has made the biggest difference. I often feel too ill to eat and most of the time I could quite easily go all day without eating anything. I am fed, because the bloke does virtually all of the cooking, but if he wasn’t around I’d live on the occasional bit of toast or the odd crumpet. I have lost all of what I put on earlier this year and more. My weight has yo-yoed a lot, but I am now somewhere near the lowest weight I have been since I was about 17. Admittedly, I am still many stone overweight, but I have lost over two stone and getting on for three. My clothes which had all got too small are now all too big. I am fed up of having nothing which fits properly, but I don’t really want to spend too much on new clothes if my weight is still changing. I have cleared a lot of stuff out, but I am reluctant to get rid of stuff in case I put the weight back on. We shall see.

Unfortunately, the way I am feeling physically hasn’t been helping my mood at all. In general, my mood has been dropping off over the last couple months. I felt a lot better during the earlier half of the summer than I did in the latter half and I felt a lot better 8 weeks ago than I do at the moment. At first, there were just a few warning signs and I did my best to ignore them. Whenever I noticed them and started to worry, I tried to stop myself because I didn’t want it to be a self-fulfilling prophesy. Worry that I was getting worse, so I got worse. Unfortunately, that strategy doesn’t seem to have helped much, as my mood seems to have dropped regardless.

I haven’t wanted to tell anyone that I am not feeling so good. I am disappointed that my recovery has stalled and almost feel ashamed. I wanted this time to be the time where I get well and stay well. Instead it’s a return to the old “one step forward, two steps back”. I am worried that if I am getting depressed again, then maybe I am to blame for it all. I wish I had made more of the time when I was well, because I don’t think I really appreciated how much better and easier things were.

I hadn’t wanted to write about it here, because I was worried about what the bloke would think, but he had noticed the drop in my mood, despite my best effort to carry on and pretend that nothing had changed. I didn’t and still don’t want to worry him. I do not want to go back to how things were when I was really ill.

I wasn’t sure I was going to tell Dr N today, but he knows me too well now and I think he could tell before I even said anything. I was there about the tummy trouble, but he asked me about my mood and I couldn’t tell him that all was fine. He seemed sad and a little concerned, but he was reassuring too. I think I feel a little better now that I am not hiding it so much.

Thankfully, although things have dropped off, they are still better than they were a year ago or back in January. Most of the time they are still a lot, lot better, but I’ve been having some bad days. Last Wednesday was really rough. I felt truly awful all day. Cried on and off for most of it and at one point instead of sorting out the huge mountain of washing I’d put on the bed, I just lay down next to it and crawled under the covers for a while so I didn’t have to face it. I pretty much cried myself to sleep, but then woke up in a panic that I had less time to get everything done. We had guests around for dinner that evening and the house was a mess, so there was plenty to do.

Unlike usually when I have been depressed, I am not especially suicidal. The thoughts come and go, but it is not like before. I was chronically and painfully suicidal for so long, I thought it would never go away, but it did. Over the summer, I stopped wanting to kill myself. I had started to see the point in life and recognised that I could have a future where I didn’t feel at mercy to my moods or awful all the time. Thankfully, despite the fact I have felt pretty low at times, the suicidal ideation hasn’t come back with such ferocity. I think I have retained the hope that I can be well again. I had lost that before, but Reboxetine has given me that back. I thought I was always going to feel so depressed that I didn’t see any point in life. There are times when I feel like that again. When I think about relapse, I get so frustrated that again I am going backwards. This makes me feel pretty hopeless and I wonder what all the point is. I sometimes just want to throw in the towel and give up, but I am resisting. Occasionally, I do want to die. A lot of the time I don’t really care if I live. Even when I have been well, that hasn’t really completely gone away, but I am managing. The thoughts pass and for now I can handle them. Hopefully, it will stay that way.

I told Dr N today that I do think there is something in the seasons. He has asked me in the spring when I started to feel better if I thought there was and I said I didn’t know. When the Reboxetine showed the first signs of helping earlier this year, it was at the same time as the weather improved, so we weren’t sure if it was one or the other or both. Often my worst times have actually been in Spring, when most people are starting to feel better. However, I think about it now and I think the seasons do have some form of effect. My mood has definitely dropped in September/October for the last three years. Last summer I was better than I had been during the rest of the year (although still much, much worse than I was this year), but things went downhill from September. The year before was generally awful from June onwards, but it wasn’t until September that things completely fell apart and I first ended up in The Priory in October ’08. I used to struggle in October whilst I was at school too, but I always put that down to an increased workload and the fact it was usually a time for deadlines and the ramping up of rehearsals for Christmas concerts and the like. So maybe there is something in it? I don’t know. I just hope that January/February 2011 isn’t as bad as 2009 or 2010.

Anyway, I see Dr M on Monday. Dr N told me to mention the seasonal thing. He said it is worth knowing and perhaps we should be aware of the rough cycle of my moods as it may help us pre-empt things. I have tried to be aware in the past, but it is hard when you often forget how you have felt before, even when you try and keep track.

He said that she may choose to raise the Reboxetine, but he is worried about the side effects. I had of course thought of this too. I considered doing it myself, but thought I had better see what she said first. I am worried about the side effects too. Things are so bad on that front, that it may not be wise. It’s a bit of a chicken and egg problem, because the side effects are making my mood worse, but to counteract that drop in mood, I will probably have to make the side effects worse. I don’t know what is worst. It’s a hard balance to strike. I don’t think I can tolerate the side effects getting any worse unfortunately. They are trying my patience enough as they are. I had hoped that when I was settled on these meds, the side effects would subside and although some of them have done, the tummy troubles just seem to get worse.

Anyway. I have written enough for now. This is a long post and I must try and get to bed. I have been waiting for the bloke to come home from playing computer games with friends, but he is not back yet.

Good days, Bad days…

with 12 comments

I’ve had a lot of good days lately. My mood has picked up sufficiently that I am feeling almost “normal” at times now and certainly manageable at others. I have actually felt happiness or contentedness, something I wasn’t really sure was possible any more. My concentration has been improving and my confidence is growing.

I have started to contemplate the idea that I may finally be heading towards some form of recovery. Maybe, just maybe, we have found the drug that works, despite the problematic side effects.

I have been foolish though in thinking the bad days had passed. I had hoped that I wouldn’t feel that bad again, at least any time soon. I really didn’t feel good yesterday. I woke up feeling low and felt worse as the morning went on. For the first time in a while I felt seriously suicidal, as opposed to the passing thoughts that had been floating around, but which I could brush off relatively easily. I was having to really fight the urge to just thrown in the towel. I felt anxious and uneasy. I’ve been struggling with strange dreams and nightmares lately and they were bothering me. Everything just felt wrong somehow. I wanted to crawl back in to bed and hide there. It felt like nothing had changed. I thought I was past all that, but I was wrong.

Things did start to improve again yesterday evening, but I am feeling a little shaky still. I feel like I’ve been knocked off balance and I’m struggling to right myself.

I am trying to tell myself that this is normal, recovery isn’t a smooth process and bad days are to be expected, but it doesn’t ease the disappointment. Telling myself this didn’t make yesterday any easier.

I hope that things will pick up again, but I am worried that this will set me back. One of the things I struggle most with is the idea that I will never be completely well again and there is always a fear of relapse. A bad day is like a mini relapse and it makes me question if it is all worth it. What is the point in carrying on, if in 6 months, a year, 20 years I end up severely depressed again and try to kill myself? My thinking may be screwed up, but I just wonder if I may as well get it over with.

I had been thinking about going back to work. I do miss it and I’ve been missing it even more when I’ve felt okay. I wonder why I am not there. I know I have only just seen Occy Health and I agree that I’m probably not ready to go back just yet, but I was starting to think that I will be able to do it. Even 3 or 4 weeks ago when I was there, I doubted it would ever be possible. A run of good days has made me think it is, but this bad one has put the doubt back. I worry that it would only take a couple of bad days at work and I would be back where I was before.

I’m still really struggling with the future. I panic when I think about what lies ahead. I am scared of therapy. I am scared of going back to work. I am scared that I will relapse. I am scared of commitment in all shapes and forms. I am scared of getting married. I am scared of buying a house. I am scared of getting old.

I am frustrated, because I was meant to be seeing Dr M on Thursday and I got a phone call today to say she has cancelled. I am disappointed, as after yesterday I felt I could really do with seeing her again soon. I wanted to discuss the Reboxetine. I think it is time to increase it to the “therapeutic dose” (4mg b.d.). I hope that those extra 2mgs will be enough to stave off the bad days. I just hope it isn’t enough to tip the side effects into not-worth-it territory. She was also going to discuss what we can do to ease the side effects, particularly looking at sleep again – the insomnia is the biggest problem. I quite wanted to know what ideas she had come up with since I’d last seen her.

I now have to wait another 2 weeks. It is going to end up being 6 weeks between appointments by the time I eventually see her and we were aiming for every 2-3 weeks, so that’s not so good. It may still be better than the CMHT, but I could have done with seeing her sooner.

I guess I will just have to manage how I am. We will see what happens. I’d like some more good days.

Reboxetine…

with 27 comments

I’ve been taking Reboxetine for a couple of months now. I started on a stupidly low dose and even with that I started to struggle with side effects. It has been increased a couple of times now and the side effects are a nightmare… BUT I THINK IT IS WORKING!

Reboxetine is meant to be taken in divided doses; 4mg morning, 4 mg at night, but I haven’t even got that far yet because of the side effects. One of the biggest problems is insomnia. I started on 2mg in the morning which wasn’t so bad, but then they needed to add the night time dose and that pretty much stopped me sleeping at all. I couldn’t even tolerate taking 2mg at night without it keeping me awake. So they decided to move the full 4mg dose to the morning, which was a little better. I still wasn’t sleeping very well (around 4 hours a night), but it didn’t seem to make things much worse than normal.

The dose was increased though about 3 weeks ago and we now have a problem. I can’t really take a larger dose all at once because Reboxetine has a fairly short half life and wears off pretty quickly. It was suggested I took 4mg in the morning and 2mg at lunchtime. The problem with the lunchtime dose is I often forget. If I’m out and about I don’t normally remember to take it with me or even if I’m home I keep telling myself I’ll go take it and never do. If I end up taking it mid-afternoon or evening I have a nightmare trying to get to sleep. If I take it late at night I usually get to sleep initially, but wake up an hour or two later and spend the rest of the night awake. Even if I take it at the right time I still have a problem sleeping. The only time I seem to be able to sleep properly is around 7am-10am in the morning when the meds have worn off, when ideally I should be getting up. I am struggling with the lack of sleep and I’m pretty sure it isn’t helping ease my headaches.

Aside from the insomnia there is a plethora of other side effects to contend with:

Sweats are a big problem and at times I get so hot I seem to start shaking or I feel faint and dizzy. This happens even when it is really cold outside and I’m wearing short sleeves. I must look ridiculous going around in short sleeves when everyone else is wrapped up in coats and scarves. I end up carrying my coat around everywhere because I can’t bear to wear it, but that means I get wet!

The Reboxetine has killed my appetite too. At the moment it is not unusual for me to eat nothing all day, for my bloke to cook me dinner and for me to eat half of it and then give up. The only thing I seem to want to eat is sugar. Everything else makes me feel sick, especially chicken for some reason. I don’t know if that has something to do with the fact I spent a weekend throwing up a couple weeks ago and one of the things I’d eaten was a chicken slice, but it’s a little annoying. I’m fed up of the nausea. It does have an upside though. I have lost a bit of weight over the past couple of weeks, although I’m sure if I wasn’t just eating sweet things then I probably would have lost more. I may be eating less than normal, but I think I probably eat healthier than this usually.

I am still getting the occasional attack of upper abdomen/chest pain too. It was assumed this was down to acid reflux and it does seem to have eased off over the past couple of weeks, so maybe the omeprazole has helped on that front. I just hope it doesn’t get worse now that I’ve completed the course of meds.

Add the common medication annoyances of constipation and dry mouth to the list and you have a pretty comprehensive list of side effects. The stuff is making me feel pretty rubbish, on the physical side at least.

The side effects do seem to ease off a little when my body has had a chance to get used to the dose, but it is really not fun in the meantime. Dr M is pretty concerned about the side effects too. She has been reluctant to increase the dose each time I’ve seen her, although she knows she needs to. I’m not even on the recommended dose yet (4mg b.d.) and she thinks I will probably need a high dose eventually, so that means I’ve got a few more of these increases to tolerate. I hope that by persevering the worst will pass, but I know that every time the dose is increased again, all the nasty side effects will be back worse than ever. I don’t know if I can handle it getting any worse. I almost wonder if she should just stick the dose up to full strength and see what happens. I think I’d rather feel absolutely dreadful for a couple of weeks, rather than pretty rubbish for a couple of months. I just don’t know if I’d tolerate it or not.

Dr M even seems to be considering taking me off the Reboxetine because of the side effects, but I am loathe to give up on it yet. I can feel it improving my mood and that is a big thing for me. It is the only antidepressant to have done that without sending me completely doolally. I have tried so many different antidepressants and other medications that I had kinda given up on the idea that I’d ever find something to lift my mood. This has changed that. I now have some hope that medication may eventually help me.

I hate though that I find something that may actually help my mind and my sodding body won’t tolerate it. If I find something my body can tolerate, it does nothing for my mind. Why can’t I have both? There must be some meds out there that will work and not make me feel ill?

So, yes. The side effects may be doom and gloom, but I do think it is working. My concentration is improving and I feel able to do more. I don’t actually mind getting up in the morning now. I may be knackered from the lack of sleep, but at least when I wake up I am not filled with this absolute dread of facing another day. It may sound clichéd, but I feel a little lighter. I don’t feel like I am being crushed by this overwhelming sadness any more. Things are by no means fixed, but they are definitely better than they were.

The intrusive thoughts are less and have changed too. I sadly can’t report that the suicidal thoughts are completely gone, but they are different and less often. Before, I had reached a point where I was absolutely certain that death was the only sensible option. It was all that I could think about and it didn’t matter what I was doing or how busy I was, it would be in my mind and it was the ultimate goal. I wanted to die and I spent all day thinking about how I was going to do it as quickly and painlessly as possible.

I am not certain any more though. I still find life and the future pretty hard to comprehend, but I don’t see suicide as inevitable now. I am still struggling to resist the urge to just give up on everything, but I haven’t already given up. The thoughts are mainly impulsive ones now, rather than the pervasive ones that were there before. Generally, the thoughts are kept at bay when I am busy and they only really hit me when I am anxious or upset, or at night when I am struggling to sleep and have time to think. I am keeping myself busy to push the thoughts back, but I can’t do that forever.

When I do stop to think, I am scared. I am scared that it won’t take much to push me back down the slope. What if I have to stop taking the Reboxetine because of the side effects? Will I get worse again? What if I don’t keep getting better? Will I give up again in frustration? What if I just give in to the impulsive thoughts that linger? What if, what if, what if?

I am scared by the thought of recovery. I am frightened by the future. I have spent so long assuming there is no future, it is impossible to know what to do with one. I don’t know how to live my life if I actually get it back. Dr M and New Social Worker ask me what I want to happen in a month, 6 months, a year’s time and I have no idea. I have no real aspirations because I have given up on them all.

I wrote about wanting to go back to work, but I am not sure I can actually do it. It is too hard to comprehend. I have been off for so long I don’t know if I can remember what it is like to work. Illness, ECT and medication have all messed with my brain and I don’t even know if it functions enough for me to work anymore. I feel so stupid and slow these days.

I am worried that I am not strong enough to recover. I am scared of therapy. I worry that it will make me so much worse in the short term that I won’t be able to cope. I don’t even know what it is meant to achieve. If my mood is improving with the medication, maybe it is more down to chemicals than Dr M is willing to admit? I know there are other problems, but I don’t know how therapy is going to help. I don’t even know if or when it will ever happen. I’ve been waiting so long it is pretty hard to imagine ever coming to the top of the list!

I feel like a coward. It seems so much easier to just give into the suicidal thoughts even now. I know things are improving, but I am too scared of what lies ahead. I have got so used to the idea of suicide that it is almost comforting. It is strange. Suicide is a coping method, as much as a get out clause.

I know I just have to face it. I know I need to stop worrying and thinking about it, but I can’t help it. I guess everyone facing the idea of recovery has these thoughts. I have been trying to ignore them, but they have been niggling away at me.

I have to fight these thoughts. They fuel the negative and intrusive thoughts that linger. I am trying.

Written by intothesystem

Thursday, 1st April 2010 at 9:25 pm

ESA Medical…

with 9 comments

I know I’m updating a lot all of a sudden, but I guess there are things I want to document this week. My talkative mood is probably helping too.

I made it to my medical this afternoon. I am so glad it is over.

I was all over the place during the interview. The doctor kept asking the same things over and over again and it was tiresome. My head was spinning, thoughts racing, agitation brewing. I kept forgetting what I had just said and found myself getting more and more worked up. I couldn’t keep still from the agitation. It didn’t help that she wasn’t following things, but I don’t know if that was me talking too fast or her being a bit slow. She kept mixing my doctors up (I know it’s complicated. I still have 2 psychiatrists!) which was getting really confusing.

She didn’t seem to ask me much about what I can and can’t do. She did ask if I got up, dressed etc (yes, with bullying from my bloke). She asked me if I went anywhere (yes, if someone takes me – I mentioned Creative Remedies). She asked me if I saw friends and socialised (sometimes). She asked about driving (no, not since October 2008).

We talked a little about my overdose in February and what happened afterwards. We talked about ECT. I told her when I’d been in hospital. We talked about my current care – The Priory and transfer to NHS, who does what. She asked me a million times if my doctors knew what I was telling her and who was most up to date with everything. I didn’t know why she was asking that so much. Maybe so she knows whether to trust any information she gets from them or so she could check up on what I was saying?

She kept asking me about suicidal thoughts. She wanted to know why I hadn’t tried again if I still experience the thoughts. She asked me literally 30 times if I had any active plans, maybe even more. She seemed quite concerned when I was honest about the extent of my thoughts, even though I have no real means or firm intention to act at the moment.

I was forced to talk about anger and violence. I couldn’t deny that it has been a problem of late, but I didn’t want to be seen as “dangerous”. I felt so uncomfortable talking about it.

We talked about mood. I found it hard to convey what it is really like. I told her about the current agitation and how this is a fairly new development. She suggested the agitation could have been caused by anxiety about the appointment. I didn’t think it was and denied it at the time, but since I’ve thought about it some more I think it may well have contributed. I really was all over the place whilst I was in there and anxiety must have been exacerbating the situation. I tried to describe the aching, dull, flat, numbing depression that has lingered on and off for ages. I tried to describe the mixed agitated depression that is often a problem. I don’t think I succeeded on any account.

I mentioned that my partner had given up his job to care for me and she asked me about this. Is he with me all the time? How often does he leave me on my own? Who does what in the house? Do I ever go out on my own? etc. etc.

When we went over my meds, she seemed surprised that I am taking melatonin and even asked if it’s a hospital-only prescription. Considering melatonin can be bought over the counter in the US, it does make you wonder why it is so reluctantly used over here. The CMHT seemed surprised too.

At one point towards the end, she left the office to go ask her colleague something and I couldn’t help but burst into tears. I’d been holding myself together up until then, but the stress of it all tipped me over the edge. I don’t know what it was as I barely ever cry these days. Girlie hormones probably aren’t helping at the moment, but even still it seemed ludicrous. Unfortunately she came back in whilst I was trying to pull myself together and then asked me a million questions about why I was crying. I was worried she would think I was putting it on for effect or something. I genuinely couldn’t help it, but was so embarrassed and paranoid about it.

Although she asked me a million questions I don’t know if she has got anywhere near enough information. Most of the stuff didn’t seem to be very relevant to whether or not I can work. Maybe she was just nosy? I guess that’s her job.

I cannot convey how erratic the whole appointment was. Questions were being fired in all directions and I was so mixed up I couldn’t answer her. My sentences were blurring into one. I was jabbering on and on and going off on tangents. I didn’t say half the things I should have. I was not clear at all. I’ve been going over things in my head since, trying to make sense of it all. Trying to work out her intentions and what she was thinking and asking. I know I should just forget about it and wait for the results, but my head is just looking for things to think about.

One thing I have noted is the clear effect of stress. I was anxious and stressed by the situation and I could not deal with it at all. I was turned into a whirlwind of agitated confusion. I’m just thinking about work and similar situations where I have to answer questions and think about what I’m saying. Conference calls for example. There is no way I can handle one at the moment. It’s okay doing that with a doctor that is trained to deal with it, but it is not okay to talk like a madwoman in front of your boss.

In some ways my inability to deal with the situation may stand in my favour. I suspect now I probably came across quite mad. After all, I need her to think I am too ill to work. The problem is, I think I may have come across *too* mad. I was incapable of answering her questions and I’m worried I may have messed up in some way. I’m worried I didn’t answer things clearly enough or that I missed things out. I am paranoid that she was trying to catch me out. I’m really worried she will think I was putting it on or making things up. I wasn’t, but I wasn’t “myself” either and that could be problematic.

Afterwards I was tired and didn’t really want to do anything. The session took it out of me and I needed processing time. Kinda like therapy actually. I guess it was similar in that I had to talk a lot about how I was feeling and what has happened.

Unfortunately I wasn’t really given that processing time as my bloke wanted me to do stuff. He forced me to clean my car, which took ages at it was filthy. As I’m not driving at the moment my lovely little car spends most of its time sat on the drive. It has been sat still so long that green slime was growing on all the window seals. Not good. It’s looking better now, but there are still bits that aren’t quite there.

My thoughts are still racing. I walked the dog this evening and I thought that would help calm me down but it hasn’t. I was distracted thinking about the medical, work, suicide, random pointless stuff, everything. I have music spinning around in my head on top of everything else. The “We buy any car” advert is driving me mad… we buy any car, we buy any car, any, any, any, any, we buy any car… Make it stop, please!!

I suspect I won’t be updating quite so much in the next few days. Nothing is happening. We are taking the dog to a breed show on Sunday, but that is all I can think of. I will see Dr N sometime at the end of next week. I have Creative Remedies too, but nothing unusual or exciting coming up.

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?