Sep 132011
 

Saw NewVCB last Wednesday morning.

Not much to report, really, and even if there was, as you’ll be able to tell from the appalling calibre of the following, I’m still not really in the form needed to competently review it.

She asked how things were and told her everything was fucked, thanks to my idiotic decision to reduce my Seroquel dosage. She checked that I was had gone back up to the 600mg dose, and I confirmed that I had, and had been doing so for about a fortnight.

Long and the short of it is that she claims it’ll take up to six weeks back on the high dose for things to start to improve. Wonderful. Well done, Pandora. It would be less annoying if it wasn’t my own fault. She encouraged me not to berate myself – she says patients do it all the time, and that if nothing else, it demonstrates to me what I do and don’t need. Well, maybe so – but I did this years ago when taking Fluoxetine, and should have learnt from that experience to leave such things to the quacks. But nooooooo. I know better, don’t I? Twat.

Anyhow, naturally she asked why I’d decided I’d half the dose. I explained about the horribleness of the hangover effects and the preposterous weight gain. I said that I’d be willing to tolerate the former for now (and as she noted, if and when I go back to work, I am more likely to get a ((post-hangover)) afternoon part-time job anyway, since most part-timers prefer mornings), but that I hated the weight gain issue because I was down to a size 16ish at one point (I hadn’t been that size since I was 16), and that having put most of it back on was pretty soul-destroying.

Her plan, then, is to wait until my mood has re-stabilised on my current medications (which seems unlikely to ever happen to me right now, but she opines to the contrary), and then we can look at how to play this in the long-term. She does, to be fair, acknowledge that even ignoring the physical issues surrounding my gargantuan size, it’s not good for my mental health to see 14 rolls lopping down around my knees, hiding even the briefest glimpse of my toes and their ingrowing nails. What she has suggested is reducing, though not eliminating, the Seroquel – and then adding in a mood stabiliser to make up for the loss of those same properties from said drug.

She specifically named Lithium and Depakote, though she expressed a mild reluctance regarding the latter; she laughed and said that she knew I was filled with abhorrence at the mere mention of breeding, but that nevertheless, she had to be very, very careful about the prescription of the thing to ‘fertile females’ on a ‘just in case’ basis. Apparently it can seriously fuck up a foetus/embryo.

I really don’t give a fuck about that, as – as she rightly noted, though I’m not sure how she figured it out as I don’t recall ever discussing it with her – I fully intend to never become pregnant. However, I think I read somewhere that it can interfere with the mini-pill, which I take as a contraceptive and fuck-off-menstruation-and-related-pain medication. A quick look just now has suggested that it doesn’t stop it working, but could increase levels of hormones in one’s body. Which could be a bit wank as I’m not unconvinced that oestrogen has an effect on mentalism, specifically depression (sometimes of the particularly vile variety known as ‘agitated’).

She did say, though, that she would prescribe it (regardless of my presumed ability to conceive) if she thought it best, on the balance of the foetus issue versus its active psychiatric indications. I was initially quite encouraged by this, because I’m not sure how I feel about Lithium: I’ve heard of others gaining weight on it (and one friend was constantly ill whilst taking it), so what would be the point in cutting the Seroquel (which I know works)? So, I thought, bring on the Depakote. Except that, since then, I’ve read the article on it on Net Doctor and see that it too can cause weight gain!

So, maybe either it or Lithium would mitigate the undeniably shitty hangover effects of Seroquel, but it’s quite possible my main concern would not be assuaged in any way. So what would be the point in modifying my current cocktail which, whilst problematic, has shown itself to work very well in terms of its indicated usages, only to find myself at the mercy of the same cunty side effects I’d hoped to avoid anyway?

All that said, I have known people to take mood stabilisers (Lithium in particular) who’ve found that it completely changed their life. Indeed, the Net Doctor article on it states that it’s a very good medication to take to boost the effects of pre-existing anti-depressants. So if I could get my depression and its related anhedonia/lethargy/etc to sod off (it’s never really gone away – it’s only got a bit less shit), then I might be more willing to leave the house and get some exercise to combat any extra weight anyway. But that’s a bit of a punt, really.

Have any of you any experience of Lithium and/or Depakote, and if so, what’s your view on it/them – both in terms of how they help (or don’t) psychologically, and on what the side effects are? If you take an alternative mood stabiliser (whether a ‘true’ mood stabiliser or an anti-convulsant) and you’ve found it useful and/or lacking in side effects, could you tell me a bit about it too please?

NewVCB also mentioned other anti-psychotics such as Risperidone, which typically have lesser weight issues than Seroquel. However, as a form of anti-compensation for that, you lose the mood stabilisation, so one such medication would again presumably be needed in that circumstance.

Despite my dreadful mood, I managed to crack a joke during the appointment, and was pleased to make her laugh. She asked me about suicidal ideation, and I told her all I could think about was my body flying off the Golden Gate Bridge or the high-rise apartment blocks close to my house.

“But don’t worry,” I added drolly. “I suffer from vertigo*, so…”

(* And it is ((usually, though not always, height-triggered)) vertigo, as opposed to acrophobia. I don’t really have the latter, bizarrely).

She laughed out loud, caught herself on and apologised, then started laughing (almost hysterically) again. I told her it was meant to be humourous and to laugh away. I like humour in this arena. I remember once ages ago that C cracked a joke (oh look – it was my very first therapy post. How quaint) about how my footballing allegiances were not at all good for my mental health (especially true that fucking season) – a comment made viscerally, for which he then apologised. Fuck that. Don’t apologise! Joke away. I mean, if you didn’t laugh, you’d have to fucking cry.

Anyway, medication issues aside, I handed NewVCB a copy of my last post, and that coupled with her usual questioning determined that I am “very clearly” in the midst of a major depressive episode. However, at least A and Mum are usually about somewhere, and my suicidality is operating “at fantasy level”, so there is unlikely to be any “danger”. I’d say that the lack of danger comes more from avolition and apathy rather than anything else, but there you have it. I shall, most likely, remain alive for the next while.

As I left the appointment (having managed to blag myself a script for Diazepam – which frankly I don’t particularly need, but insurance is always good) she said, for the second time since I first met her, “nice to see you, Pandora.”

Incidentally, the first time she gave me a complimentary goodbye of this nature, I was also similarly mental to last week (and both occasions were caused by fluctuations in medication, rather than being distinct ‘episodes’ in their own right). Why do I find that probably coincidental and innocuous fact so intriguing and revealing?

In other news – I haven’t written anything in the last week…BUT! I’ve had this laptop completely closed – it’s literally not been open once – since…fuck, I don’t know, last weekend? Although I have tweeted some articles and suchlike, I haven’t checked Twitter at all (ditto G+ and the odious Facebook). In this complete abandon of social media, I’ve been working on The Book. I’ve not written anything, as noted, but I have been studying the distance learning writing course I enrolled on when I first went off work a few years ago, and have been especially concentrating on the modules on novel composition. Much of it seems obvious – although this blog is factual and autobiographical, sometimes the narrative of posts takes on a tone similar to fiction, so I feel I have some pre-existing understanding of the idea. However, there has also been a lot of benefit in what I’ve studied to date, and I feel cautiously confident about The Book and its plot at the minute.

Furthermore, in my absence from internet sociability, for some reason I’ve been internally bombarded with quite a number of creative fictional ideas that I think I can turn into short stories, novellas, or perhaps a second The Book. There’s one about which I’m especially hopeful, which was garnered from a disturbed, haunting dream this very morning. At least nightmares have some purpose!

On Thursday, Wendy Perriam, whose excellent book Broken Places I reviewed for Mind, emailed me to thank me for said review. This was a wonderful buoyancy both for my own sake and for that of my writing (which Wendy was kind enough to compliment, which was incredibly flattering coming not just from a published author, but also from a published author who I hold in high regard). I asked her for a few tips, which she kindly gave me, and it’s added to my sense of ‘I can do this and it won’t be completely crap’. I’m not undaunted by any means, but neither am I totally petrified of my own potential incapacity.

The weekend was quite good. I’d been apathetic about going to one of our regularly organised poker nights on Friday because that meant fucking seeing people, but in the end it was fairly good craic – and guess what? Muggins won :D It’s my first win in a long time but it sees me atop the leader board. I’m the only woman in the whole group, yet the stats show me as the best player. Suck it up, gents!

On Saturday we met W, A’s best friend who was back in Norn Iron from England for the weekend, and ended up spending all day talking complete and utter bollocks and laughing at puerile nonsense. It was good. In keeping with what’s been occupying my own life lately, I suggested a writing challenge to W and A, an idea that both seemed to embrace for their own reasons of escapism and intellect. As well as just being fun (what even is that?), I think this could be useful in terms of my self-imposed deadlines – if A and W are in competition, I am going to be more driven to compete within this cause myself.

So, all in all, ostensibly things are good – but the reality, of course, is far from as black and white as that. I’m back into a firm agoraphobic, hide-in-the-house-and-brood-with-the-blinds-closed mode. But I’m keeping up with the studying element of my (hopefully) soon-to-be The Book, so there’s a sliver of a silver lining (try saying that after six pints of pale ale).

I’m seeing Christine tomorrow. She asked me, the last time I saw her, to do two things before tomorrow’s appointment: (a) ask Daniel to write me a reference for the voluntary position I was considering applying for and (b) get in touch with Nexus again to organise my second stint of therapy with Paul. Re: (a)…well, I have asked Daniel for the reference, to which he has agreed. However, I’ve not filled in anything of the application form, which therefore renders the request redundant. As for (b)…no chance.

Normally speaking, it seems like an uphill battle (at a bloody 85° slant) to acknowledge the mere existence of others, which both of Christine’s challenges require. I simply can’t face any communication without A holding my hand (literally and metaphorically). Beyond reading, I can’t really do anything off my own bat, and even if I could, I wouldn’t enjoy a milisecond of it. I haven’t had a bath in about a month. I keep trying to rewatch Babylon 5, but I can’t concentrate on it. I’m scared, I’m low, and I’m so, so tired. But I have something to cling to, for now at least.

Anyway, any advice you have on Depakote, Lithium or indeed any other mood stabilisers would be greatly appreciated. Thanks folks.

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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 022011
 

I’ve been taking 300mg of Venlafaxine for a week now. A week is damn all in the context of anti-depressant medication, I know, but I’m actually feeling cautiously optimistic about it. A and I had a really good weekend; I’m not saying that most weekends are shit per se, but experiencing raw fun and pleasure is, as you can imagine, rather rare for your Not-So-Humble Narrator.

Also, last night we saw a very professional and wonderfully authentic production of King Lear. I was actually proud that I was able to go, even though on paper I would always have been keen to do so; last week I’m pretty sure it would have been impossible, and even if I could have dragged myself to it, I wouldn’t have been able to concentrate for any more than about three seconds. When you’re watching an intense Shakespearean tragedy, concentration is clearly a pre-requisite, so that would have been a fucking disaster. As it was, I was actually able to both follow and even enjoy the play, which surprised and gratified me greatly.

I’ve felt fairly level over the last few days (as my Moodscope results, unscientific as they are, would appear to attest – currently they’re about 20% each day, which is much better than the standard 1% or 2%), but I (unlike NewVCB, apparently, in the context of our last appointment at least) am well aware that I have a secondary or at least differential diagnosis of bipolar disorder, type II. All anti-depressants carry with them the risk of (hypo)mania, and that presents a slight concern. It’s particularly noteworthy for me as I genuinely have no conception of what is ‘normal’ contentment/happiness, and what is psychiatric pathology; I simply do not have a proper frame of reference from before mentalism. Arguably, if you hold to the medical model at least, the mentalism was always – to a greater or lesser extent – there anyway, thus rendering a frame of reference devoid of it impossible.

I’m reminded of Freud’s old dictum about the transition from ‘hysterical misery to common unhappiness’, or whatever way it was that he put it. Let me make this clear: I am still strongly depressed, still suffering the usual intrusions of PTSD and occasional psychosis and dissociation, and am still terrified of leaving the house (particularly alone – although I went to a non-Paul appointment by myself yesterday, about which I was very pleased). Drugs don’t cure people – actually, as you know, I don’t believe that anything actually cures people – but maybe I was too quick to condemn Venlafaxine. Maybe, to use the old phrase employed by myself, both VCBs and doubtless countless others, medication can at least take the edge off the ‘hysterical misery’.

So, so far, so acceptable. In other news, I’m on a diet again and, again, am cautiously hopeful that I can stick to it. Since I’ve been taking 600mg of Seroquel, my cravings for sweet stuff have spiralled out of control. A few weeks ago I ate six bars of chocolate and three Creme fucking Eggs in one day! Unsurprisingly, I’ve gained 11 lbs since the last time I weighed myself, which was a fucking year ago (I know I have a dangerous personality, so I keep away from the scales. There’s no danger of any imminent eating disorder given my humongous size, but I don’t want to step onto a slippery slope and become obsessed with my weight). To that end, yesterday, I procured some Slimfast, and have found that the Cafe Latte flavour can (again) take the edge off my craving for such ridiculous amounts of crap. This is all weird to me, because savoury rubbish rather than sweet stuff has always been my weakness. This is why I opine that Seroquel, not just me, is to blame. Anyhow, if it fails, it fails. I’m also planning to re-quit smoking next month, but again – if I don’t, then I don’t. There’s no point in self-vituperating about it (that’s easy to fucking say, mind you…). I want to lose weight and get back off cigarettes, but if my mental illnesses don’t like that, then I am a slave to them. All I can say is that I’ll try.

For all my positivity in the last 600 words, though, there has been a lot troubling me in the last few days too – I mean, yes, the usual pervades my mind (abuse, fear, therapy, blah de blah). But it’s not just that. A lot has been afoot in parts of the mental health blogosphere of late, and it has left me feeling very disillusioned. I’ve been angry and frustrated on behalf of the personnel in question, and furthermore it left me questioning why the fuck I even write what I do here. I was actually asked this question by a third party fairly recently (respectfully, I’d add), and defended myself on the grounds that this blog is nothing more than a personal journal.

Is it though? When I sat and thought about it, I’m not really sure any more. It’s not meant to be anything more, but to my surprise it’s morphed into something more popular than I could ever have expected when I started writing it in May 2009. The thing is, sometimes I feel pressurised to write, to the extent that I get irritated by my ‘need’ to blog. This is especially true of my reviews of therapy sessions, which are by their nature very long. I mean, I could reduce them to abstracts rather than specifics, but then all the minutiae would all be lost and forgotten to time, and I don’t want that. I want all I can possibly remember here, for me, for posterity, for recollection of the healing points made, and for help in avoidance of the bad. But, perhaps paradoxically, the more I have felt under pressure to sit down and write said posts, the less I have been able to do it. My motivation, minuscule as it was in the first place, erodes completely. I find excuses to avoid writing. I feel anxiety rising from the pit of my stomach – not because of the content I wish to record, but because of the recording itself. It’s pathetic, I know.

What all this culminated in was this: I wrote two posts that I haven’t published. Both declared that I was taking a (possibly lengthy) break from writing here (at least publicly); one entry was bitter and angry, one more measured and considered. I sought advice from another blogger and from A, and decided to wait before I published either.

Cue today. I went out the back to smoke and sat down and just thought about it for a long while. For all the negative sides to it, and for all the unpleasantness of the last few weeks in parts of the Madosphere, I think I have done something worthwhile in writing this blog. For myself. If it is somehow worthwhile for others as ‘entertainment’, a form of advocacy or whatever, then that is a very beneficial side effect – but with no disrespect intended at all, I don’t write it for you. The blog is public merely because I value feedback, support or advice for myself, but if commentators/readers derive catharsis from it, then that’s an excellent and gratifying incidental.

So I will not be taking any sort of extended break. I’m not sure how I’ll catch up on all the psychotherapy stuff, but I’ll work it out sooner or later.

To be clear, if people don’t like the realities they read in the mental health blogs out there (regardless of who the author may be), then – as I’ve said a million times before – then DON’T FUCKING READ the mental health blogs out there. Just click the ‘x’ on the top right (a variable location if you’re a Linux user, that said), and go the fuck away. S.I.M.P.L.E.

Otherwise, readers, Twitter friends, etc, you do (I hope) know that I value you all very, very deeply. Without social media, and without this blog, I wouldn’t have made so many wonderful, gentle, kind, genuine and supportive people – in fact, not just ‘people’, but ‘friends‘ - and for me that actuality easily trumps the negatives associated with what I do here. Thank you all for continuing to follow the life and times of Yours Truly, and for all your amazing encouragement, friendship and kinship.

Onwards and upwards.