Into the system…

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Posts Tagged ‘violence

ESA Medical…

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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.

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