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Posts Tagged ‘trigger

*Sigh*…

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

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

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

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

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

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

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

Written by intothesystem

Tuesday, 17th November 2009 at 1:19 pm

A long week…

with 8 comments

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

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

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

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

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

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

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

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

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

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

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

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

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

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