Jul 262011
 

Seroquel has tended to dictate that I sleep until at least 10.30am each day, and often much later. When I say ‘sleep’, I don’t necessarily mean that literally, because of course Seroquel regrettably loses its soporific effects over time, and I have an apparent predisposition to insomnia anyway; however, one way or another, the hangover effects of the drug leave me in a zombified stupor the whole of each morning.

Seroquel may dictate that I don’t do anything at all in its wake, but unfortunately of late circumstance has demanded the polar opposite. You may recall that A and I were burgled (for the second time) about a month ago. Two requirements arose out of this: one was the need to urgently repair the damage caused by the tossbags responsible (that being the broken back gate and the door between the kitchen and living room) and the second was, in respect of our probable desire to move, to get the house into some sort of cosmetic order. A and I live in perpetual mess and don’t really give a shit what the house looks like ordinarily. Of course maintenance of a house is a general chore to anybody, but I appear to have a specific phobia of it. Not that I’m using that as an excuse to get out of it, mind you, because I wouldn’t fucking do it whether I had said fear or not. (At least I’m honest, yes?).

Anyway, A’s father and step-mother have a mate who’s good around the house. He paints, tiles, joins, does minor structural work, blah blah de blah fucking blah blah. He’s trusted, being a family friend, and he charges reasonable rates. Excellent. Brilliant. Amazing.

Does that sound sarcastic? It is, to an extent, but seriously – we’re very lucky to have this connection, because of course it would be just our luck, were we to seek out a similar sort of individual via classified ads or something, that the person contacted would be an unscrupulous wanker with a criminal record the length of one of my more…um…exploratory posts on this blog (that’s c. 4,000 – 5,000 words, for current readers fortunate enough to be uninitiated). Furthermore, the bloke in question is a nice bloke; he’s fairly easy to chat to and seems to do a good job.

However. Fuck me but I’ll be glad to see the back of him.

I have a routine. An inane and, perhaps paradoxically, fairly un-regimented one, admittedly, but something that suits me nevertheless. I get up when Seroquel allows me to get up. Then I write, read or occasionally watch the pointless but inexplicably addictive rolling *ahem* news (read: sensationalised bullwank) on BBC News 24. I sound like a work-shy fucker, I know, but even in these not-so-heady days of pseudo-”recovery”, this is genuinely all I am capable of. I don’t like lying in half the day, and I don’t do it through choice. I do it because the medication forces me to do it. In turn, the threat of potentially dangerous psychosis forces me to take the medication.

Our builder-joiner-decorater-Everythinger, and his penchant for showing up at eight in the bloody morning, has screwed up this seemingly idle but oddly workable routine on an epic scale. I haven’t felt this chronically and soul-destroyingly fatigued since I was plagued with literally months on end of insomnia. In fact, I’d go so far as to say that it takes me back to when I was still at work full-time and plagued with literally months on end of insomnia (God, that’s a vile memory. I would lie in bed, awake, all night – every night, for months. I’d get up at 7am and almost throw coffee beans down my throat. Then I’d go to work for 8am, stay there to 6pm in a futile effort to wear myself out, come home, stare blindly at the TV for a few hours, then repeat the whole hideous cycle for another day, and another day, and another day. And this was before my 2008 breakdown came a-callin’. How the fuck did I do that every day?).

It’s the Seroquel’s fault, of course. I would probably be tired if I wasn’t taking it, but I don’t think I’d be so completely devoid of any atom of energy whatsoever. It’s the drug that demands that I rest (if you can call existing in a stupefied Seroquel hangover ‘rest’) so much, and when I don’t do its bidding, it punishes me, like some embittered monarch lashing out at a traitor.

Anyway, whilst I’m on the themes of Seroquel and working both, herein lies a huge issue. Last month, Differently left the following comment on my rant about knobend MP Philip Davies (who, incidentally, was one of the ones to question the Murdochs and Rebecca Rebecka Rebeckah Rebekah Wade Grant-Mitchell Brooks over the News of the Screws phone-hacking allegations – how the hell did Parliament let him on that committee?):

…realistically I’m unsure that I’ll ever be able to work full time, since a combination of my experiences and the meds I take mean that managing 2 weeks at 10-4 left me looking physically unwell, pale and tired and feeling horrendous, thereby meaning that I hope to work part-time…

Seaneen, who is presently working full-time, has also alluded recently to how much Seroquel has inhibited her at work in the mornings (and she has, as a consequence, withdrawn from it).

I had been thinking, much to my chagrin, that part-time employment was becoming my own only realistic option as far as future return to work goes, but I kept trying to tell myself that eventually that wouldn’t be the case, that eventually I could back to working full-time. But this exhaustion-debacle with the Everythinger has left me seriously questioning that feigned optimism.

I cannot function without devoting most of the morning to a complete state of bleugh. I just can’t. Not whilst 600 daily milligrams of Quetiapine addles my entire system. So, if I continue to take the stuff – certainly at this dosage – there is no way in hell that I could work full-time. It is simply impossible.

I keep looking at other people (especially, to my personal feminist frustration, other women) – randoms in the pub, the street, whatever – and I silently ask them, how – how?! - can you possibly work eight hours a day, five days a week? How is that even remotely physically feasible? And then I remember that I too did this – for years, some of it whilst doing a sodding postgraduate degree – and I shake my head in stunned disbelief. How did I do that? How was that even approaching possible? Was I an imposter in my own body? (I do love a bit of ((self-directed)) Capgras). I am certainly not that person now. Was I ever that person, really? Who was I then? Who am I now? How did it all change? (And, you might ask, who fucking cares, Pan?).

Those that are masochistic enough to regularly read this blog may be remember that, at my last psychiatric review, I asked NewVCB if I could consider reducing my dosage of Quetiapine. You may also recall that she was potentially amenable to this, citing a maintenance dose of 300mg.

This could help, and I might notice the difference more markedly after coming down from such a high dose, but my recollection of taking 300mg in the past was that it was still very – if not quite, as currently, absolutely and unequivocally - debilitating the next morning. Besides, I’m not convinced that 300mg adequately functioned on the psychotic features of my illness. It sated some of the voices a little I suppose, but it was only when I started ingesting a daily whack of 400mg upwards that they actually shut the fuck up (and random, probably stress-related delusions are notwithstanding).

So, herein lies my dilemma. You all know I don’t buy into anti-psychiatry ideals and (conspiracy?) theories. Seroquel works. I know I whinge about weight gain and have launched a virtual diatribe against the stuff in this post, but it has truly made my life better. As long as I have my get-over-the-hangover routine, I am fine. Venlafaxine at a high dose has worked wonders – well, quasi-wonders, anyway – in terms of my mood; Quetiapine has probably aided in that too, but the key issue with it is that I am almost entirely without psychosis at the minute, and have been (bar that one episode the other week, as linked to in the previous paragraph) for aaaaaaaaaaages.

But, much as I don’t want to be normal in what seems to be the standard, societally accepted version of the word, I want to be able to do the things I always wanted to do. In other words, I want to work. A career – not a job, a career - was all I ever really wanted. Thus far, mentalism has denied me a career, but has periodically at least allowed me to have jobs, which may have – in another place and time – led to careers. Is being mental now going to rob me of both possibilities? Will I be a dolescum forever? Are part-time workers actually commonly sought by employers? Besides which, why is it fair that A works full-time (fuck knows how he does it) and I don’t?

Bah. I don’t know. It looks to me like I have a choice between relative sanity and full-time work. Please don’t tell me to kick the Seroquel, by the way. It isn’t going to happen, at least not in the short to medium term. I’d rather not live with a bunch of nefarious fucktards telling me to kill myself (or, worse, others); I’d rather not live with Paedo following me about the place; I’d rather not have to make sense of contemptuously vicious peccaries and stupid fucking gnomes randomly harassing me; I’d rather not live convinced that cameras are watching my every bloody move. Waaah waah waah, whinge whinge whinge, ad infinitum.

We could argue the toss about the true roots of psychosis all we might like – Paul of course held (and, presumably, holds) that psychosis is an entirely logical response to severe trauma, and he may well have a point – but I don’t think I’m ever going to go all R D Laing/Robert Whitaker on this. At the risk of being infuriatingly repetitive, Seroquel, for me at least, works. It does exactly what it’s indicated to do. (Or, as I mistyped, tindicated to do. Geddit?!!!?1?!!!?11????!!eleven?!?! It does exactly what it says on the tin? Tindicate? No? Meh. Sorry. Humour ain’t my strong point).

So, sanity or full-time work. Full-time work or sanity. Why is nothing ever simple or easy in this enforced existence that the fabled they (not my ’They’ ;) ) smugly refer to as ‘life’? Why do we always have to make choices, to compromise, to ‘make do’?

Am I an immature little brat for being irate that mutual exclusivity exists in this context? (Actually, don’t answer that).

Anyway, enough.

(And yeah, by the way, I have sold out and stuck PayPal begging buttons on some posts and on the sidebar. What can I say? I’m a slave to a capitalist world, a traitor to my fellow benefit claimants, a betrayer of my lefty principles, a self-serving money-whore of evil, a rabiator of [insert hated multi-national conglomerate of your choice here] proportions, a twat, a dick, a __________, a &%$(“($, a…yeah, you get the idea. A few of you also did ask about it, in my defence ;) ).

marketing

Jul 082011
 

In the absence of Paul – I know I’m still catching up on writing about my final few sessions with him, but they did in fact finish about three weeks ago – I’ve been seeing Christine at fortnightly intervals. The last appointment was last week.

Although things have been generally going OK, as testified by this blog throughout recent months, over the last week or so they’ve taken a slight downwards turn. As things stand, I can manage it;I suppose it could perhaps be a mild depression (by my standards – I think that probably equates to moderate by official scales? [EDIT: I am correct, apparently. I just took this test again and scored 52, which is within the bracket of 'moderate to severe' depression. Well, it's better than having gotten 82 back in February, I suppose..!]), but we’ll see.

I guessed that the whitecoats would claim that my mood dip was reactive, for the following reasons:

  1. the cessation of the treatment with Paul;
  2. the burglary; and
  3. the fact (as yet unmentioned on this journal) that FuckBitch Queen of All Levels of Hell Aunt of Evil arrived in the country on Wednesday morning (more on this anon).

Appointment With Christine

I guessed correctly. It didn’t come as massive shock to the system when Christine carefully opined that it was “hardly surprising” that I “wasn’t at” myself. In my view, my moods are, by and large, non-reactive (I’ve always maintained, and I continue to maintain, that my particular blend of clinical depression is melancholic rather than atypical), but I can see why she came to the conclusion she did. I’m not saying the above has not affected my mental status at all, but I think this goes in cycles too. Interestingly, NewVCB seemed to primarily agree with me, but I’ll get to her later.

I was with Christine for quite a while, though not quite as long as the last time I saw her. In a supposedly surreptitious fashion, she kept glancing at her watch, which mildly irritated me, but I do appreciate that she has other people to see. Anyhow. We discussed how I’m feeling in the wake of the end of therapy (fine, though I’m not sure she was convinced of that, given that she kept bleating on what a “big deal” it apparently was for me), how I’d dealt with the burglary (relatively well) and medication.

Seroquel has been a wonderful drug for me. It really has made my life a lot better. However, predictably for an anti-psychotic, it has sent my appetite completely out of control, and a lot of weight I’d lost has piled right back on. It wasn’t always like this, though; I’ve been taking Seroquel for about a year and a half now, and it’s only since the dosage was increased to 600mg daily that this has happened. I did a fair bit of whinging about it to Christine.

The long and the short of it was that I should discuss the issue with NewVCB (well, I’d never have thought of that…), but – reasonably enough – Christine thinks that this would be the wrong time to reduce my dose of the stuff. I agreed that I’d like to retain this level of relative stability for several more months before I’d seriously consider reducing it, particularly if there are likely to be stressful events hovering about.

She kept emphasising how important it was that I remained free from psychosis. In light of our last meeting, where she said that NewVCB was reconsidering my previous diagnosis of BPD, I am now wondering if they think that I actually have some sort of specifically psychotic illness – Christine, at least, puts very heavy emphasis on that side of things. She’s worried that if I started reducing my intake of Seroquel that all the voices and visions would come flooding back. Her concern troubles me, because when she heard that I had suffered from command hallucinations and hadn’t been sectioned (or voluntarily admitted) at any point in my life, she was utterly stunned. So if I go mental again, if ‘They‘ come back or some other(s) turn up, will she recommend the bin for me?

Am I Still Proper Mental?

She asked me if I was still free from the voices, and I was pleased to respond in the affirmative. But then she asked me about possible delusional thinking. I denied any, but I must have shifted my eyes suspiciously because she kept probing me about it. I admitted, then, that yeah – I might just have a little bit of paranoia hovering about. Might. Just maybe. Perhaps.

In an admission of narcissism that shocks even me, I blathered on about how GCHQ read this blog, and about how people still have cameras up watching me. The funny thing about the cameras is that they go wherever I go. Yeah, I am really that important!

Naturally, Christine enquired as to the strength of these alleged delusions. I said that I rationally knew they were a load of bollocks, but that…well, that I still had the fear that the “paranoia” was grounded in at least some truth. For example, I have a friend, William, who’s a policeman. None of us know exactly what it is that he does, because it’s some shady, cloak-and-dagger, national security-esque thing that requires his utmost discretion and a solemn vow never to speak about it in detail to anyone. What he has told us, though, is that the amount the security services know about people, their movements, their online habits, etc is truly shocking. He also confirmed that yes, they probably are scouring insignificant online bullshit like this blog – though he contends that it’s probably based on keyword searches, patterns and the like, rather than some agent sitting in a dimly-lit room in Cheltenham reading every word that people like me are typing.

You see? As the old adage goes, just because you’re paranoid doesn’t mean they’re not watching you.

I told Christine about all this, and of course she pointed out that, given that this is a public blog, it probably could be read by GCHQ and their kin. However, she picked up on William’s point that it’s unlikely to be in any detail, unless something suspect comes up. She laughingly asked if I had somehow threatened national security in my writing of this blog, and I had to concede that I haven’t. She sorted of tilted her head as if to say “I told you so,” and then started quizzing me about the cameras.

“I know the cameras aren’t there,” I said, exasperated with myself, “but I just can’t shake off this stupid irrational belief that they are.” I’m a walking conta-fucking-diction.

As I said to her, in a way having this kind of insight is almost worse than being completely under the control of a delusion. Not that I’m saying the latter is nice – far fucking from it. But when you know that your beliefs are (potentially) psychotic (is it even psychotic at all in that case?), then you have the added pressure of arguing with yourself about the damn thing all the time. You might as well have one of those tossers that doesn’t believe in mental illness with you at all times, telling you to “wise up” and “pull yourself together”. The rational, ‘well’ side of my mind isn’t particularly sympathetic to the sicker part.

The upshot of the conversation, though, was that the “paranoia” isn’t too intrusive. It doesn’t stop me from doing things I want to do (no, anhedonia, avolition and agoraphobia are the culprits there), and most of the time it’s operating at a fairly peripheral level rather than being right in the middle of my conscious mind. Christine seemed mostly satisfied with this, though I suspect she’ll be coming back to this issue at each session for the next foreseeable future.

Rant: Aunt of Evil is on this Landmass!

We then moved on to an issue about which I was, according to her, “very angry”. I thought I’d been speaking perfectly reasonably and rationally, but Christine did not concur. The topic in question was the arrival of Aunt of Evil in this country. Those of you that have been reading this in the long term may realise that this means that this is the third time the stupid fucking bitch has been here in less than two and a half years. If you’re not so intimately acquainted with this blog, or indeed if you’re a normal human being who doesn’t have a photographic memory for bullshit, I have a long running dispute with the woman and her immediate family. They reside in the USA, and frankly their existence in Ireland makes me wish that air travel had never been invented (other than for the flight that sent them across the pond in the first place, that is).

The story of my feud with Aunt of Evil, Georgie, is a protracted and convoluted one that I’ve never discussed fully here – not because I have a problem with any of you knowing about it, but simply because other people’s familial dramas are really not that interesting. Indeed, most of it is not that interesting even to me, so I’m not going to waste my time or bandwidth or put myself at even greater risk of repetitive strain injury by detailing it all. You can see contextual posts here, here, here and here. There’s probably more, but those links should give enough information, and I can’t be arsed going through any more archives.

Now, of course given my history with Aunt of Evil and her spawn, I am not going anywhere near any of them. In that way, their presence doesn’t particularly bother me – but what does is that I know that (a) Aunt of Evil (AoE) has a skewed perception of why it is that I loathe her, and have no time for her family and (b) I will be talked about between them all, behind my back, despite my express fucking instructions to my mother – and to AoE herself – that I am not a suitable subject for their conversation.

My ma told me the other week that AoE has been going around whinging that V, the deceased lump of shite that forcefully donated his sperm in order to facilitate my conception, “has achieved something in death that he didn’t in life – the breaking up of the family.”

This fucking enraged me. AoE has always been a wanker, and I’ve never liked her. However, given that she purports to be a Christian and should therefore have a corresponding set of morals, I did expect her to at least behave honourably when V snuffed it. I did not expect V himself to behave thus, in life or in death, so her contention is completely erroneous. V was a cunt. I expected him to behave like a cunt. I did not expect her, her offspring and her offspring’s mate, to be have like cunts. And they did.

What is so fucking difficult to understand about that? It’s not fucking about V. It’s about them. Simple.

I advised my mother in no uncertain terms to appraise AoE of the above – but I don’t think that she will. My mother is lovely, but she is, in this instance, also a hypocrite. She agrees with my position on AoE and her twatpack, yet she has quite happily arranged to see them, have them stay with her, etc etc. In fairness to her, she has this idea that [cue best EastEnders-esque put-on accent] faaaahhhmmmlaayyy is one of the most important things that an individual can have on this Earth. I respect her view, but I fundamentally disagree with it. One of our friends, G (of intellectual fame, waaaaaaaay back in 2009), put it best:

Family is genetics; friendship is earned.

Quite. I don’t get this societal obsession with family for its own sake. If the people concerned are nice, if you have something in common with them, if they’re a laugh, whatever – fine. If not, why bother? Seriously. I don’t understand it. What ties do you have to such people other than DNA?

I so wish I could show you my cousin’s wife’s blog, so that you could have a laugh (or, indeed, recoil in repulsion) at her utterly nauseating nice-middle-class-ism, and pictures of the nice house that they bought with the money that should have gone to my mother and me (tangential point of amusement: she has 23 blog ‘fans’ on Fuckbook. I’m not exactly some bigshot on the hateful service myself, but at least I have over 670. Mwhahahahaha! :D ). I see from said blog that she’s up the duff again. I wonder how they’re funding that brat Gift from God?

No, no, no – I’m not bitter or anything ;)

Aaaaaaaanyway, I gave Christine a redacted version of the story, and as I said, I thought I’d been fairly calm and reasonable in my narration thereof. It certainly wasn’t a rant like the last few paragraphs here were! However, when I’d finished, she said, “you’re clearly angry about this.”

Well…yeah. I sort of am. I then proceeded to rant a good bit about V, justifying my view that he was a knobend of Rupert Murdoch proportions by referencing his actions towards my mother during the joke that was their marriage. I said that I was furious with AoE for believing that my problem with her and her family was about him because, as noted, no one expected V not to be a dick.

She was curious as to why I care about what someone I can’t stand thinks of me, which was a fair question. The answer is that it’s not so much about what AoE thinks of me – she still “loves” me according to My Mother the Messenger, but I really couldn’t care less whether she adored or despised me – but, rather, about her consistent and unwavering failure to accept responsibility for her actions. She still thinks that what she and her family did is right. It was legally permissible, I’ll give her that. It was, however, ethically repugnant.

None of this, of course, even acknowledges my more general, more long-lasting disdain for AoE. She is self-righteous, patronising and a Queen proselythiser (she’s one of the key reasons that I had such a profound and blanket hatred of Christians until I met lovely people like Phil Groom and bourach). Once, when she asked Mum why I didn’t like her, my mother – bless her – was honest, and told her exactly that. AoE affected to be shocked by this information, but honestly – on this side of the Atlantic there is no one in this shittily sprawling dynasty of mine, including my mother and the other Bible bashers like Suzanne, that strongly disagrees with my stance on that.

Back to the Fucking Point, Pan…

To get back to the original point of this post, Christine feels that it is a positive thing that I am avoiding these people; I know my limits, apparently, and “not everybody does, you know.” Nevertheless, given my levels of resentment, anger and general frustration towards them, she also thinks that this is a massive stressor for me. Perhaps it must seem that way – the rant above would appear to be clear and present testament to that – but I actually don’t think it is. I’m staying out of their way, and as long as my mother does not provide me with a running commentary on all the inevitable back-biting, I am happy to sit here at A’s in my blissful ignorance until they all sod away off again.

The appointment was basically left with her saying that if my mood dips any further before I see her again (next Friday), I can contact her, presumably to arrange an emergency appointment. NewVCB (after this week) is off for about 408 years – Christine says that all the consultants just disappear over the summer – so it’s good to at least have some professional support, especially when I don’t have Paul to bleat to. I better not go really mental though, because if it were to come to the bit and some SHO or other had to assess me, he or she would inevitably take advice from Christine as the only present person within the CMHT that knows me. And as I noted above, Christine is stunned I’ve never been binned.

So. I must retain a modicum of sanity at least until NewVCB is back from her summer gallivanting.

Speaking of her…

Appointment with NewVCB

This is Friday (albeit only into its early hours). I saw NewVCB first thing on Wednesday morning (9.30am) and felt that the appointment went fairly well. I told her that things weren’t quite as positive as the last time I’d seen her (which I didn’t record here at all, because I was in and out within minutes, and all was deemed to be well), but also said that I was happy to leave my medication as it was, and that if the downer got worse or, indeed, if it lengthily prevailed, then we could possibly reconsider this at a future appointment. She seemed to think this was a fairly sensible course of action.

I did raise the weight gain on my current dosage of Seroquel issue with her however, whilst stressing that I didn’t want to reduce the dose right now. She agreed that this was something we could think about over the coming months; according to her, a standard maintenance dose of the stuff is usually 300mg. That said, I wouldn’t like to whack the dose in half at any point, even if life was absolutely fucking amazing, so if that’s where we ultimately want to return to, then I’d have to insist that we slowly taper it down. She’s not stupid, though, so I’m sure she’d agree with that.

I told her that I was worried that, if we go ahead and do this at some point, the voices would return. “At the end of the day,” I said, “I’d rather carry some extra weight that be persecuted by ‘They’.” She nodded her assent to this, and added that in a case like mine – where the mental illness may remit at times, but usually returns in some fashion – it would be fine to have xmg as a maintenance dose, but that it would at times be necessary to whack it back up.

It sounds odd, but I was quite pleased by this statement. I took it as recognition on NewVCB’s part that my mental health problems are chronic and recurrent, and not necessarily the reactive issues that Christine had perhaps suggested (though I’d add that I don’t think that Christine thinks it’s all reactive – just that that, to her, is probably part of it, and maybe it is). This isn’t me saying, “yay, it’s all biological,” because clearly it isn’t (even if it was then that would be pretty shit – therapy would be an utter waste of time, would it not?); would I be so fucked up were it not for the ‘trauma’ I experienced? Probably not to this degree. But I’ve always maintained that I hold to a biopsychosocial model of mentalism, and she seems to concur with that.

Of course, therapy has helped me a lot, hence the ‘psychosocial’ bit. But, as I am forever banging on, I don’t believe in cures. Therapy – and medication for that matter – may help to reduce both the severity and frequency of episodes, but that doesn’t mean that the whole sorry business is dead and buried.

Anyhow, this led onto a conversation about suicidal ideation. Christine is usually concerned when I say something like, “but of course I still have suicidal thoughts, how could I not?” NewVCB, on the other hand, says she wouldn’t even believe me if I went in one day and said that I absolutely wasn’t suicidal in the least. As she says, the horrific intensity of my preoccupation with ending my life that I’ve often experienced will not always be present, but she believes – in the short to medium term, at least – that there will be probably always be some level of it.

That’s a pretty poor prognosis, I suppose, but I’d rather she was honest with me. I’ve always respected her for her candour, and even if she’s not painting the rosiest picture in creation, better that than false hope and lies.

She said that I should use this period of relative stability to think about what I can do when things go tits up again. Well, I’ve thought about it, and I haven’t a fucking clue. One thing NewVCB suggested was that I should keep the idea with me, for the next time I’m standing on the edge of some cliff with a bottle of gin and 20 packets of Zopiclone, that I have come back from the absolute brink (remember the 4th October plan, anyone?) and that therefore I don’t need to take the jump. “Use this period as a reminder when you’re that low again,” she instructed. “You can, and you have, recovered from very severe suicidality.”

Spot on: I have. However, I know from bitter experience that the mind of a person at that kind of hideously low ebb does not think like this. Well, the omni-present rational narrator in my head would certainly say, “but look, remember how well you did in mid-2011?” but the depressed side is always going to dominate that with responses such as, “yeah, but that was then, this is different. I can’t recover this time,” or even “so what? I don’t want to recover anyway.” You might very well think that both of these (and other possible) responses are thoroughly illogical, but that’s how severe depression works I’m afraid. Indeed, continuing my standing-at-the-abyss scenario, I could look down over the cliff, knowing that The Rational Narrator was right and that everything else was a crock of shit. And it wouldn’t make an iota of bloody difference.

Still, she has a point, and I’ll try to do as she says. One thing I have now that I didn’t have when I had a major crash-and-burn in the past is this blog; one crucial thing about it is that for the first time I have a proper record of something that approximates recovery, or at least a road to relative wellness. Perhaps those positive words, penned (typed) by my very own hand, could make a difference? I’m not convinced of it, but you never know.

We spent some time discussing this journal actually. NewVCB alluded to it in the context of it being one of the things that had helped me when I felt at my worst, but was careful to remind me of the dangers of becoming too immersed in the online and mentalist world, rather than in the supposedly real and sane one.

I laughed, and told her that since I’ve been feeling better, the amount of visitors here has gone way down. I still get about 200 hits on days on which I don’t post and often over double that when I do. This is far more than I ever could have expected when I embarked on this narcissistic but cathartic pursuit, and don’t get me wrong – I’m grateful to and for every person that takes an interest in this bollocks. Compared to my hits when I was posting my most morbid, morose material, though, things are definitely much less popular. I don’t mind that – I just thing it’s an interesting statistic.

In any case, I assured her that I think I’ve achieved a good balance between being here, being Pandora, and being there, being me, in the “real world”. She asked me if I was getting out much.

Ha! As if. I’ll go out alone for little errands, such as buying milk or something, if I’m feeling game. Otherwise I won’t leave the house without A, or at least without the promise of meeting someone I know well. Even then, there’s some difficulties.

I was due to meet Brian, one of my close friends, on Monday evening. Realising, however, that I would actually have to go out and, shock horror, talk to Brian, I backed out and made a frankly idiotic excuse to avoid him. (Contrast this with my intended meeting with Aaron on Wednesday, which I was going to until fate intervened. I bring this up because never, never, never ever ever ever, have Aaron and I been able meet based on our original arrangements. Something always comes up. Famine or feast, eh?).

I admitted to NewVCB that I’m sometimes genuinely scared of seeing my/our friends. Naturally she asked why, and naturally I said that I didn’t know.

She said, to paraphrase, that I need to really take some time to work out the specifics of this social and agoraphobia. I agree that the roots of it need to be uncovered, but I thought that was what therapy was for. Oh, wait. The NHS won’t fucking give me therapy, and Nexus deals with sexual abuse issues rather than this sort of fuckwittery. So basically I’m screwed.

Maybe I’ll try and look at this through writing in a future post here. I can’t seem to get the thoughts that need to be…er…thought…into my my head with any modicum of coherence, and sometimes writing about thoughts can be more revelatory than thoughts in themselves.

And that was pretty much it. Since NewVCB is on holiday now for a good while, she said she’d see me again towards the end of August or start of September. That’s a little longer a gap than I usually have between my appointments with her, but not too much so. And it’s still a fuck of a lot better than the erratic scheduling her predecessor afforded me.

Meh and Blah and Yadda and Etc and Such

If you’re still reading this, you really must have a strong interest in self-flagellatory pursuits  - but seriously, thank you. I don’t know if anyone has the lack of wit to care about me, but if you are thus afflicted, please don’t worry. I’m OK. Really, I’m mostly OK. People have downers, whether they’re mental or not. It could be a mild ‘episode’, it could be the start of something more serious, or it could be just one of those things that happens from time to time. Indeed, I’m feeling a good bit better than I was on, say, Wednesday, so it’s probably nothing much – I mentioned it to Christine and NewVCB on a ‘just in case’ basis, I suppose. I’ll be fine.

As you might imagine, sleep is an issue for someone whose blog is entitled Confessions of a Serial Insomniac. Generally, one of the most positive side effects of Seroquel has been its soporific effects, but the downside of same is the hangover the stuff gives you the following day.

The fact, therefore, that I’d been up really early from Monday to Thursday inclusive is probably not insignificant. After the burglary, we had to replace the two doors that the robbing cunts smashed through; one was in a room that has a second (undamaged) door that we also decided to change for the sake of aesthetic consistency. The bloke we got to to do the work arrived each morning bright and early, and I had to be up to greet him, make the obligatory cups of tea and share the obligatory cigarettes. It hasn’t been a particularly unpleasant effort – he’s a nice man – but it has resulted in severe fatigue. That, in turn, can be a major issue vis a vis mentalism.

Next week sees Northern Ireland’s Lovely Loyalist Love-in, the Twelfth (or, as one council is trying to politically correctly re-market it, “Orangefest”), come to pass. I have nothing particularly against the occasion despite my unionist-nationalist ambivalence (although, of course, I do loathe the contingent of wankers that set about causing trouble around this time of year – utter cunts), but neither do I care for it either. There are two days’ holidays, though, which from a practical point of view means that our door-hanger – soon-to-be our painter and decorator – can’t come out next week. So, in this way, Orangeism has done me a favour. It will allow me and my Seroquel-addled mind to rest.

Anyway, this is the abrupt end of this stupidly but predictably long post. Cheerio.

marketing

Jun 242011
 

Last night I was reading this post by GoldenPsych, and was reminded of a recent, and potentially significant, development in the saga that is my mental (ill) health – something that I had hitherto forgotten to record here.

I saw Christine, my CPN, last week, who was full of earnest apologies for having had to cancel a previously scheduled appointment with me. A year ago this particular confluence of events might have annoyed me; as it was, I didn’t mind in the slightest – particularly because she’d been ill. People don’t choose to be sick, for God’s sake. I kept telling her that I didn’t mind, but she kept apologising nonetheless. Again, this steadfast sorriness might once have irked me. Instead, I felt rather touched that she gave enough of a shit to say it first of all, and then that she wanted to press home the point that she actually meant it. I can’t say that everyone I’ve dealt with in mental health services has shown such concern.

Anyhow, the long and the short of it is that she’s “delighted” with how I’m doing. I told her about the writing I’ve been doing independently of this blog, and she couldn’t stop smiling. I went on to say that I’ve been reading pretty voraciously for a while now – and that, whilst it’s not at the lofty levels of studying the texts of Dostoyevsky or some other such self-referential literary fuck highly acclaimed author, it’s still vaguely challenging material that requires much more concentration than that to which I’ve been used since I had this breakdown almost three years ago. Christine continued to not stop smiling.

Can it be that she actually gives a rat’s arse about her patients? I mean, this is an employee of my Trust we’re talking about, not one of a properly run nor remotely respectable organisation. But hark! It seems to be true, of both her and NewVCB. Maybe I shouldn’t have allowed my hopeless experience with Psychology and wholly tiresome engagement with the responsibly bankrupt Mr Director-Person to bias me quite so much as it did. At a corporate level, the Trust is a fuckhole – but that doesn’t mean it doesn’t have some good people within its ranks.

I complained about the weight I’ve gained since I started taking 600 daily milligrams of Seroquel (I had no such issues at all at 400mg and below) and we had a conversation around that (“take it up with [NewVCB], but remember the command hallucinations were often still there at 400mg, so you have to be careful…I have a patient who was seriously ill who was prescribed Seroquel; he’s really well, mentally, now but has gone from a fit, athletic man to being over 20 stone,” apparently), the upshot of which is that I’ll raise it – without much hope of a reduction, however – at my next psychiatric consultation.

We also discussed how I live less here, on this blog, in this created online world that was my more vivid life for so long. I’d also had this chat with NewVCB the last time I saw her (which I didn’t write about because nothing happened), and they both agree that it’s a good thing. I assured them both, though, that whilst I’m living as ‘me’ – out here in the ‘real world’ of air and trees and streets and clearly embodied human beings – that I will not abandon this side of my life, at least not for a good while yet. Being ‘real’ is a good thing, but I’m not better yet, and even if I was, the support I gain from all of you would still be invaluable. Christine seemed to feel that I am striking a fair and reasonable balance.

Anyway, I was with her for ages, babbling on in the spoken word in the verbose way I veer towards on this blog with the written word, but other than the above, most of the appointment consisted of her asking y, me answering z, and her smiling in recognition of the supposed progress that z represented. One thing of particular note did occur, though.

I told her at one point that I’m writing an article for <a href="can be recovered from.”

This led to a discussion of the diagnosis. You may recall that I protested to NewVCB several months ago about its applicability or otherwise to me – my view at that stage had been that I had major depressive disorder and some unspecified psychotic condition, with the occasional fugue thrown in for good measure (schizoaffective disorder? Psychotic depression? Psychotic depression plus ((C-))PTSD?). NewVCB whined a bit about how she wasn’t interested in diagnosing me; she just wanted to treat my symptoms.

Of course, this is sensible. I don’t know why I’m fixated on diagnoses, but I always have been, even for physical illnesses. I like terms that help me to understand my conditions, even if they’re not wholly definitive and are in need of some elasticity around the edges (as I believe most mental health, and many physical health, conditions are). I loathe the terminology “label” in this context, probably because I see the validity of a diagnosis; to me, it’s not necessarily a nasty, sticky thing that follows you everywhere.

Except…in the case of BPD, it actually sort of is. Although I fully agree that I had the illness when I first received the diagnosis, I truly feel that I do not now (and indeed that I didn’t when I raised the matter with NewVCB). However, borderline is notoriously difficult to get rid of, officially speaking. Once you get it slapped on your file, whether or not it’s accurate, you can’t get it off your fucking file. So then some idiot that still views the disorder in the outdated, pejorative way that it’s traditionally been considered peruses one’s notes and whines, “oh for fuck’s sake, not a bloody borderline!”

It’s not fair, but it seems to be true. You. Cannot. Get. Rid. Of. It.

Unless, apparently, you’re me.

Christine tells me that when NewVCB first referred me to her, the latter said that she was “seriously questioning” my supposed status as a person with BPD. Christine said, “have you asked her again about it?”

I told her that I hadn’t, alluding to the aforementioned comments of the consultant on treating symptoms. I pointed out that I agree with the approach, to an extent, but that knowing what’s ‘wrong’ is still important to me.

Christine nodded empathetically. “Do ask her about it again,” she urged. “She was genuinely reconsidering the diagnosis.” Then, and I don’t recall exactly how she phrased it, she somehow insinuated that she agrees with me; whether or not I ever had BPD, I don’t now.

I will truly be amazed if there is ever a definitive statement ascribed to my medical notes observing that I am no longer diagnosable with borderline personality disorder, but the fact that the two of them are even considering the issue is hugely significant to me. It’s a measure of their competence and understanding, and (perhaps more importantly) it’s also a measure of how different things are for me these days.

I’d stress at this point (a) that I’m not completely banking on getting BPD ‘removed’ from my file; and (b) that just because things are reasonably OK at the minute, that I’m under some sort of illusion that I’m cured and will never experience fucked-up-ness again. I’m not the wisest person on the planet, but I’m not a complete fool either. Still, I’m cautiously encouraged. All of this represents a good sign.

In the absence of Paul (more session reviews to come), I’m seeing Christine at two-week intervals for the time being, meaning that our next appointment is next week. I’m due to see NewVCB the week after that as well. I shall explore this further with them both on these occasions.

(Aside one: Christine mentioned a patient whom she’d referred to Nexus. The woman had been very mental prior to going to them, but after completing her course of therapy, was “a different person”. That’s a great thing in itself, but Christine continued by saying, “I was so happy for her, I just gave her the biggest hug!” I thought this was rather lovely. She does genuinely seem to care :)

Aside two: Remember C? C of NHS-Psychology-I’m-Dumping-You fame? When I used to see him, he worked at the hospital in which I see Christine and NewVCB on Mondays, Thursdays and Fridays. My consultations with Christine have previously been on a Tuesday or Wednesday, but the appointment to which I’m referring in this post took place on a Thursday. Do you see where we’re going with this?

I didn’t go into his building, of course; it’s too small, and he could easily have spotted me. I did drive round to it though, to see if his car was there. It was. I stared blankly at for a minute or two, then turned round and left.

I don’t know what I was hoping to achieve, but the silly endeavour only succeeded in evoking a stale taste in my mouth, a vague mental conjecture as to what he might have been doing right then, at that very moment – and, ultimately, an involuntary utterance of “meh”.

A was somewhat less ambivalent. “Did you throw a fucking fire bomb at it?” he seethed when I told him, bouncing around in a fit of pique. It seems odd, really, but I think A has even more contempt for C than I do.

((For the record, in case the police/GCHQ/MI5/any similar organisations are reading this, I didn’t firebomb that or any other car and, furthermore, A was employing verbal hyperbole to emphasise his frustration and his comments are therefore not to be taken literally in the least. Sorry lovers, but one apparently now has to add these sorry disclaimers to such comments – after the Twitter joke trial farce, you can’t be too careful, can you?)).

So yeah. I don’t know if I still compartmentalise everything about C ((quite possible)) or whether I really don’t care at all anymore ((not inconceivable either)). Either way, it wasn’t him that helped me get to the stage I’m at, was it?).

Alas. I’ve had enough of composing this dull post; I just thought the above merited reporting. See you next time, darlings.

marketing

Mar 232011
 

I was writing this as a combined post of this week’s entire set of mental appointments – ie. these two and Paul – but the Paul stuff has completely taken on a mind of its own and needs to be separated from these, which are broadly factual, rather than introspective and ‘deep’. I’m feeling very belligerent tonight, and that shows in the following, and in the stuff on Paul (which I intend to publish on Friday, after the intervening two sessions tomorrow). So beware of ranting, bitchiness, cursing, nostalgia – but there’s a little hope thrown in there somewhere, too.

I’m not going to proof-read this yet either – I need to keep my flow up with the Paul stuff – so apologies if it’s complete and utter wank fodder.

This is still quite long, so here – have some clicky links :)

The CPN / NewVCB / A Random Encounter of Which I Epically Failed to Make Use in Which You Are Probably Not Interested

TUESDAY – First Meeting With Christine, My Newly Allocated CPN

The short assessment of this is that she’s actually quite likeable. I’m not really go greatly into the details of the appointment – not because it wasn’t useful necessarily, but it would simply be pretty repetitive. The meeting seemed mainly for her to get a grip on me, and take a proper, verbal history, as opposed to relying on the (fabricated) notes that are in the (fabricated) file.

She is short, fat (she makes me look slim, and that’s quite good going) and has spikey red hair. My guess is that she’s well into her 40s. She has a local working class accent, and ergo does not exhibit the middle-classness of the other members of the CMHT that I’ve met. I liked this; it made her seem more down to Earth. She called me ‘love’ a few times, which normally irritates me – but in this case, she wasn’t doing it in a patronising fashion. It just seems to be part of her demeanour.

She was rather surprised that given my history of command hallucinations etc that I’ve never been hospitalised. I was surprised that she was surprised. I said that no one within services had ever taken enough notice of me to feel hospital was a necessity, or even vaguely desirable. She had the grace to blush slightly.

Another point of interest was when she said, “…and how are things when you aren’t suicidal?”

I sat back in my chair in confused aghast. “Sorry?!”

“You do have times when you’re not suicidal?” she checked, raising an eyebrow.

“I have times when my finger isn’t hovering over a ‘buy’ button for a helium canister,” I said. “But there’s no such thing as ‘not suicidal’, is there? I mean – everybody wishes they were dead, don’t they? They just don’t don’t have the bollocks to go through with it.”

“No,” she said, firmly. “The vast majority of people do not want to die.”

I’ve read such contentions once or twice, but apart from A once saying so (and my assuming he was saying it to disabuse me of the idea of suicide), I’ve never heard it verbally. This is truly an absolute revelation to me. People actually, actively want to live?!!! Seriously????????? Why?

Anyhow, eventually she filled out a risk assessment form. This is another thing that’s entirely new to me. Christine said, “we have to do this as you know,” then upon seeing my confusion, she added, “you have had one of these done before, right?”

“No,” I said. “Never.”

I’m not saying being asked if you’re going to go out and knife the living fuck out of some poor stranger is fun. It’s not. But if these things are so fucking standard, why haven’t I experience them before?

I blame C. I absolutely, completely blame C. I’ll write another post explaining this in more detail some time. For now, let’s just say that my perennial suppositions that he didn’t take me seriously seem to have been proven. I noted with passing interest that a number of his files were to be seen in the filing cabinet in the room. As I idly eyed the documents, I wanted to take my lighter to them and watch them burn to ash. Fucking cunt of cuntishnessfuckerywankshafthatefulness. But anyway…

Christine quizzed me on suicide, and it was instantly evident to her that if I was going to do it, that I would succeed. They find that terribly frightening. Hahaha! They think people will say, “oooh, look at me and my overdose!” and that they can breathe collective sighs of relief as it’s unlikely to be seriously dangerous, so when she asked me if I had any ideation about taking ODs, I laughed right into her face. She didn’t need to ask me why, but I nevertheless said that I would only even consider taking a suicidal overdose if I could acquire the complicated ingredients that are fundamentally necessary to be peacefully fatal. Since I can’t – legally or otherwise – I’m sticking with my party box.

That said, I’m not actively planning anything, and may not do so for some time. Possibly ever, but I don’t believe that. Whatever the case, in short: I’m still not sure exactly what I’ll be doing with Christine, nor how long I’ll be seeing her for. But based on Tuesday’s meeting, I do think that maybe – just maybe – she can be useful to me.

WEDNESDAY – NewVCB

The appointment went pretty well, despite my being irrationally terrified. I’ve known NewVCB for over a year now, and she’s generally been quite supportive of me, but for whatever bizarre reason, I have developed a terror of psychiatry.

She was very nice to me today. She’s usually pleasant enough, but occasionally lacks sincerity in my estimation. On this occasion, I found her to be thoroughly genuine – this is a breath of fresh air in mental health services (particularly in psychiatry), as I’m sure so many of you can appreciate.

I could go into a lot of detail about the appointment – wank on about the dialogue, the subtlety of the non-verbal communication – but I don’t see the point. The essence of it was this: I told her about how I became hugely upset last night, in relation to the Paul session that I was originally writing here, and she opined that therefore my therapy with him must be going well as that demonstrates that I’m starting to experience “emotions” in an “appropriate, constructive way.” She asked if I agreed.

I told her that crying was a sign of weakness and that I thought my behaviour had been pathetic. I said that I was meant to be an aloof, calculated, analytic droid.

She asked me to look at it from her perspective, and I was forced to admit that of course, rationally, it is progress. That objective knowledge doesn’t stop me from fully believing at an I Feel It Like This level that crying and emotions are a pile of fuck. She laughed and said that she didn’t expect me to change my view quickly, but that the fact that I could even look at it logically without flying into a self-flagellatory rage was encouraging. Broadly speaking, I agree with this. Sympathetically, she said, in what I think was an attempt to reassure me, “crying is not a sign of weakness.” Hmm.

We discussed Venlafaxine, as you might imagine. I suggested that maybe I had been too quick to condemn the drug the last time I’d seen her, and said that I understood from some sources that it came into its own at higher doses. NewVCB agreed, stating that its operation on norepinephrine was more pronounced from about 300mg.

I essentially asked her would she increase it again. Things are much better since I’ve been taking 300mg, but I think they could be better again. When I was at sixth form school and on a laughably high dose of Fluoxetine, I functioned fairly well. To that end, I am quite happy to take a laughably high dose of something else if it can assist me in re-achieving such a state. I’m aware that Venlafaxine is a nastier drug than Fluoxetine, of course, but if it works at higher doses – well, then it does. I’m prepared to accept the (numerous) negatives that go with it.

She said that I would need to have an ECG, for which she would refer me; apparently it’s worth having whilst I’m taking the 300mg dose anyway. All being well with that, she agreed to raise my dose of the horrid-but-seemingly-useful stuff to 375mg next time I saw her. “That’s as far as I’ll go, though,” she added.

Hmm. That’s potentially unfortunate, but I do understand the medical rationale for it.

We had a brief conversation about Nexus. Obviously, I’m now into week 18 with Paul, and judging by the discussion I had with the secretary when I first approached the organisation, that only leaves a matter of weeks left. NewVCB seemed unaware of the time limitations. I was interested to note how she phrased the relevant question:

Are they going to give you a more appropriate timeframe than we [scrunches her face in dismissal at her use of the word 'we'] gave you here? [Dismissive hand gesture in C's general direction].

I told her how long was left, and said that whilst it concerned me, I felt that if anyone was likely not to play by a silly rulebook, it would be Paul. I hope that assessment turns out to be the case. This kind of complexity cannot be solved in 26 weeks.

As I wrote the other day, an appointment letter for NewVCB had arrived stating that she wanted to see me on 6 April. I asked her, given that this (ie. Wednesday’s) appointment had been organised as well, if she wanted to keep the later one. She said that she did, because she still wanted to keep an eye on me. It might have been nice if she’d seen me within the fortnight she originally proposed, but I’ll forgive her. Just this once ;)

As I was leaving she said that she knew things weren’t ‘good’, but that there was clearly a change in my demeanour since last month. And I think there is. It’s weird, and I don’t trust it. Epically severe depression is seemingly my default setting. I’m not not depressed, of course. But I am a little better. Is the simply the drugs, or is it them plus therapy? Or just the latter? I don’t know. Either way, I cautiously welcome it, but again, I don’t trust it. I’ve had stable-ish periods before, and they always fall flat around me eventually. So I will leave presumption on the issue for another time.

An Odd Encounter

Something really interesting happened when I was waiting for Christine yesterday. I mean, it won’t sound interesting to you probably, but it was for me. As I walked into the CMHT building/Old Bin, I caught the eye of someone in the waiting room, and did a fucking double-take. It was the mother of my long-lost friend, Louise, that I discussed here. As I noted in the post, she had been diagnosed with schizophrenia when I last heard of her.

We (A and I) reported to reception, then proceeded to the waiting room ourselves. I walked past Louise’s mother (Brenda), terrified to speak to her. I saw out of the corner of my eye that she looked up at me, but I withheld my own gaze and sat down as far away as possible, my mind racing.

For the sake of context, my address is at Point A, my alma matter about six miles west at Point B, and Louise’s last known address about six miles further west from that. I tried to figure out why her mother was there, then, at my CMHT. It’s nowhere near their house.

Of course, in supposing that she could not attend the same place that I do, I made (given my experience) the fundamentally stupid error of assuming that this fuckhole country has adequate mental health services. Louise’s house would be equilaterally between this CMHT and the next one in the Trust. Ergo, her possibly attending my local bastardhole is an entirely feasible eventuality.

I stared at the floor until a blonde woman poked her head round the door. Brenda got up to talk to her, and I leaned forward to gawk. I was hoping that Louise may emerge from an appointment or something. If she had been there, I would have spoken to her. Of course, I thought, it was entirely feasible that Brenda was there for her own reasons. Caring for a schizophrenic daughter is bound to present its own set of mental challenges.

However, the blonde woman sort of touched her sympathetically on the arms, uttered a few hushed words to her, and led her further into the building. A few minutes later, Brenda left alone.

It is daft of me to speculate, but still – I am supposing Louise went mental, and Brenda had to take her to the CMHT…and leave her there (for assessment and possible admission – there is no psychiatric ward at this hospital, but of course they have contacts with others). Brenda and the blonde woman seemed to be on familiar terms, so I’d guess it’s unlikely that this was the first visit.

Fuck my social anxiety. I so wish I’d just spoken to Brenda. What was she going to do, fucking punch me? I still think about my old friend a lot, and have tried desperately on many occasions to find her on Facebook or at her old email address, or whatever. I had the most obvious fucking opportunity in creation to re-establish contact the other day, and I blew it. I mean, even if Louise was completely psychotic, her mother knew me, and could have passed on a message when she was a bit better. Stupid, stupid fucking cow!

I even considered asking NewVCB about it today. Obviously she would not be allowed to tell me anything, but I considered telling her what I’d seen, and asking her if Louise was somehow under there care, could she pass on my email address (without her confirming or denying Louise’s presence or otherwise within the system). But, nice as NewVCB is, I thought it was most likely a futile request, so I kept my mouth shut.

Alas.