2012 Continues its Shittery, But Reports of My Death are Greatly Exaggerated

Good evening (or morning, if you prefer). It must have been about three weeks since I last posted, which is pretty much a record absence for me in the almost-three years that I’ve been writing this blog. There are some underlying reasons, I suppose, but primarily my disappearance can be attributed to the usual culprit: that of crippling, fuck you anhedonia. I haven’t been as badly afflicted by the phenomenon since I was a teenager. I mean, depression always carries this demon in its clutches, that much is a given, but it exists in degrees. The depression that has blighted my life so far this year was, initially, relatively free from anhedonia and its cousin, avolition – I blogged quite prolifically around the time of Maisie’s death, after all. I gravitated here when that happened; as it had been, Confessions became my outlet, my place to vent, my catharsis and analysis. In the last few weeks, I haven’t felt that at all.

This apathy and utter dearth of motivation have been compounded by an exhaustion of a magnitude I cannot describe. I’ve been sleeping poorly, and waking early when I do manage to find slumber for a few hours – but it’s more than just that sort of tiredness, for I’ve lived with that for many years. Every step I’ve taken recently has taken the effort that I’d imagine normals would put into a bloody marathon. My head constantly droops somewhere down in my chest – giving the unfortunate impression to the cameras and any other onlookers that I’m orally pleasuring myself – because I have not an ounce of strength to hold it up. My mind is either blank, or thinking repetitive, monotonous, lifeless thoughts. I have, on many days, literally had to tell myself what to do: “move your left foot now, Pan. Good, now move your left. No, no, fuck, sorry! Move your right. Yes, right. Good. Left now. Well done.” And my body aches with this…something. Aches aches aches. And sometimes my mind joins it: it can’t even summon the energy to feel anything with my usual levels of desperation. It currently doesn’t feel raw pain, just like my body doesn’t. It just aches.

[Coincidentally – or not? – the last time I felt tiredness on this scale was back when The Everythinger was here in August. More thrilling musings on that later…]

Perhaps ironically, therefore, I think the depression to which I alluded has abated a little. I’m confident that were I to take any of the usual diagnostic tests that I’d still be deemed ‘severely’ depressed, but, again, it’s about degrees. I do feel a bit better than I did when I last wrote. This could be the normal cyclical run of my supposed manic depression, or it could be down to Lamictal. I mentioned last time that Christine was going to ask NewVCB to increase my dosage of the aforesaid drug; however, NewVCB adamantly refused. Her rationale was something that I didn’t entirely comprehend – something along the lines of not raising the dose when I was planning to cut down on Seroquel, which I think translates as “don’t let her get too used to the stuff just yet, because she’ll need a fuckload more when we start titrating the Seroquel down.”

Why, then, has the drug possibly made a difference? The reason is that effectively the dose has increased. Confused? Well, I’m not sure if I mentioned it before or not, but since I’ve been taking 100mg of Lamictal, that has (theoretically) meant ingestion of one tablet in the morning, and one in the evening. In effect, this has meant one in the evening only – ie. 50mg daily – due to the toxicity that is the infamous Seroquel hangover. Even when I had dezombified five hours later, I simply forgot to take the damn thing. Of late, however, I’ve taken to leaving a strip of the stuff on the bedside table, in order that it is the first thing I see each afternoon morning. With the sun rising earlier, I’m waking (assuming I’ve slept, which is not always the case) earlier anyway, so the morning tablet is taken at a more appropriate time, meaning that the stuff floating around my body is more regulated and less quickly half-lifed away.

So, that’s medication. What else? Ah yes. As reported in the last post, I’d received the brown envelope that all ill or disabled people in the UK fear most: that of a social security assessment form (an ESA50, in this case). I also noted that Christine has said she’d fill it in for me. When I saw her last week, she had indeed done so, the poor, lovely woman. Bless her.

Can you spot the impending ‘but’? To my regret, there is one. To be honest, she’d really written very little about my hallucinations and delusions, referring to ‘hearing voices’ or ‘feeling paranoid’ – and that was qualified by the hideous words of ‘sometimes’ or ‘on occasion’. I hadn’t the nerve to say this to her, but I felt that this wasn’t really an accurate presentation of the issues, so when an brought it home, I modified some of the content, and added stuff in. For example, it asks something like, “are other people frightened by your behaviour?”, and she had ticked ‘no’. I don’t agree with that; I know from experience that people find experiences of those like ‘They‘ deeply disturbing and, yes, frighhtening. Even some cheery ramblings of, “oh, look, that sign’s trying to tell me I’m beautiful!” sees neighbouring eyes widen in horror and concern. And something as ostensibly simple as a panic attack can have people shifting their eyes, crossing the street and then running like the hammers from hell.

By the time I’d modified that which I felt needed alteration, of course the form looked like I was trying to make my condition sound worse simply for the purpose of getting more money, rather than attempting to present reality. I therefore asked my mother to ring the Social Security Agency (SSA) and ask for a new form. “Whilst at it,” I instructed, “ask them why I’m actually being assessed.”

She responded a few hours later advising me that they refused to tell her anything and that I’d have to ring them myself. Cue fucking panic stations galore. Asking me to use the phone, as ever, was like asking me asking me to translate War and sodding Peace or Beowulf into Sanskrit. But needs must, so after perusing the SSA’s website in painstakingly close detail in a futile attempt to obtain an email address for a relevant member of staff, I took a deep breath and called them.

Naturally, this was not a simple process. At first the robotic female who ‘answered’ my call advised me, after talking frustratingly slowly through six years of patronising explanatory shit and in doing so costing me a lot of money, that my call could “not be taken at the minute. We are sorry.” (Read: “we’re on our fag break. Fuck off”). When I called back immediately, after listening to the same initial bollocks, Robot intimated to me that my call was in a queue. How surprising. “Please continue to hold and someone will be with you as soon as possible. Or, if you prefer to call back later, our opening hours are [x, y and z].”

I did not prefer to call back later, so held. Robot repeated the soft and still enragingly slow monologue about 100 times. Why the fuck do they use that voice? Are its lulled t
ones supposed to hypnotise you into compliance? If so, they’ve supremely failed. The only compliance they’ve evoked in me is a willingness to comply with the invoice I’m expecting from the people I sent round to break Robot’s non-existent legs (and yes, GCHQ, that is/was a joke and is not to be taken literally, seriously or as anything other than just a joke. OK?).

The real cunt, though, was fucking Vivaldi. Fuck Vivaldi. To think once I appreciated what I then found to be the majestic chords and melodies for which he was responsible. I swear to fucking God that I nearly rang Matt Smith’s agent to inquire about TARDIS rental. A trip back to 1677 to prevent the birth of the composer seems to be the only solution to this widespread problem; it’s always Vivaldi that is played when you ring any sort of call centre, and so it proved in this case. In between Robot came the first 30 seconds of (I think) Summer. Over and over and over. It would put a sane human being into an asylum.

In the end, the call itself was very straightforward. The girl was friendly, if clueless – when asked why I was being reassessed, she said, “um…well, I think they do this every year, I’m not sure though.”

“Even for people in the support group?” I checked (interruptive spluttering and stammering not included. You can obtain these with my all-singing, all-dancing in-blog purchase function, denoted by a button displaying the word ‘Donate’, at the bottom of this post).

“The support group?” The poor cow sounded genuinely mystified. “Uh…uh, yeah, I think so.”

It was a futile effort, so I told her I’d lost the ESA50 and asked if she’d send another. She cheerfully told me that this was not a problem, that she’d get someone to do it forthwith, and – apart from checking if Mum could ring on my behalf in future (yes; I just need to give details on the form) – that was really that. A simple, inoffensive, unconfrontational discussion that still left me hyperventilating. I wish I could overcome this fucking terror. My only other serious phobia is the old formulaic one of spiders and, as a general rule, that doesn’t interrupt my daily living. Sadly, if I ever want to work again – and I do, I do so much, when I’m well enough – my farcical and excessive anxiety about phones will significantly interfere with my everyday functioning,

Why should it? Why can’t people move into the 21st century and use fucking Twitter or email for their communication needs? Fuck phones.

I can’t believe I just wrote eight paragraphs about a phone call. I become increasingly ridiculous by the day, dearest readers. Moving on, I have now been back under the watchful eyes and perked-up ears of everyone’s favourite psychotherapist, the inimitable Paul, for three sessions. I will actually discuss these in more detail, though to my abject alarm, I’ve lost the notes I kept on sessions two and three. Now, the reason for my apprehension is to do with the fact that they could easily have fallen into the wrong hands, if I am in correct in my assumption that they fell out of my bag or something. However, I will admit to also being irritated for an altogether less ethical reason: I will not be able to record these two appointments here in the fashion to which I’ve become accustomed. Fuck’s sake. This blog has taken over my life. Incidentally, that’s something that actually came up with Paul – in session two? – but I’ll leave you veritably on the edge of your seat in anticipation of that. I’m sure you’re on the brink of self-immolation because you simply can’t stand the wait any other way. Burning ‘grounds’ you, to use modern therapeutic parlance.

What else? I suppose before getting to The Big Thing that I should apologise to many people on Twitter. I dip in and out of it erratically; even if I’m sending tweets, I am not necessarily reading others’ messages, or their @s or DMs to me. I often tweet by text message, and now have a quirky little iPhone app that allows me to tweet under this identity whilst being in another account. So it’s not that I’m ignoring you; I just don’t always see you. Every so often, I log in and see a few messages to me, and sometimes reply, but I’m pathetically incapable of catching up on everything. I don’t know whether this is social anxiety, increasing apathy, an identity crisis or just my being a total knob. Whatever the case, I’m sorry.

Right, then. I live in Northern Ireland, as most of you know. People on this island like to drink alcohol – a lot. Once a year, something comes up that seems to grant them complete impunity to engage in this pursuit: St Patrick’s Day. Perhaps it wil not shock you to hear that I loathe this occasion with a fucking passion; I have a pretty low tolerance for the obnoxious behaviours that many irregular drinkers display when inebriated out of their skulls, and I can’t cope the busy-ness around the place. This year, the event fell on Saturday past. A and I went out for dinner but had to come straight home, which is not at all common for us on that evening of the week. We’re usually in our local.

Anyway, the silver lining around the cloud of St Patrick (who gives a fuck about him anyway? He sounds like a bellend to me) is that A gets the day off (or gets it off in lieu when, as in this case, it’s at a weekend). Monday was therefore free, so we went out on Sunday to make up for our inability to do so the previous evening.

Exactly 51 minutes after we’d left the house, A’s phone started ringing. When he withdrew it from his pocket, we were both perplexed to observe that the caller was my mother. Thinking she was trying to get hold of me, but that my phone had lost its signal or something, I answered it (yes, yes, phone phobia notwithstanding).

The alarm was going off. If they can’t get hold of A or me, they ring my mother first, as she’s closest to our house, and then A’s mother second. A worked out the purpose of my mother’s call, and got ready to leave. I hung up and told him I’d stay in the pub; I would only hold him back by accompanying him (he’s a much faster walker than I am), and anyway, I reckoned it was a false alarm. That used to happen all the fucking time, to the point where I’ve wondered of late how the company responsible for running the thing had managed to improve their product so vastly. So A went back himself, advising that he’d call if anything untoward had happened. Otherwise, I supposed, he’d just return.

A few minutes passed, during which I caught up on some blogs on my Google Reader. In the middle of this, though, I was interrupted by a phone call incoming from my brother-in-law. Truthfully, at my core, I knew why he was ringing – but I let myself pretend that he was calling about joining us in the bar, especially given that he and A had exchanged a few messages about the outing earlier in the day. I duly ignored him.

When my mother-in-law’s name appeared on the screen of my phone, although I again tried to ignore the ramifications of this telephonic confluence of events, I really knew the game was up. This time I answered. She told me that they’d also called her and that my brother-in-law, who was at her house as it transpired, had called the police. In return, I advised her that A had gone back to the house to check that things were in order.

I’d only just hung up when A phoned. It wouldn’t be the last discussion via this medium that day…God, I wish
I believed in exposure therapy. I got a lot of potential practice with it on Sunday.

I knew as soon as I answered that he was horribly distressed. It doesn’t take a skilled conversationalist to decipher the first intake of breath before a single word is spoken; cheer, shock, thrills, anger – they and many more moods besides can be deconstructed in that split second. I’ve often heard parents say that when their kid reaches a few weeks or months old that they can tell by the ‘type’ of cry it emits that it wants x or y. Maybe this is a similar type of thing.

A’s gasp was one of shock and panic. Jesus Christ, I thought within the nanosecond left to me. Not again. We were burgled last only back in June, for fuck’s sake!

“They’ve taken the TV [42 fucking inches! In a heavily-populated terraced street!], the X-Box, the PS3, the iPad…” he was gasping. “They’ve smashed the door between the kitchen and the living room in…”

“I’m coming now,” I said. I hung up and called a taxi.

I could go into my usual level of detail about this, but it’s late and I’m tired. So…

  • The cops had been when I got home, but had apparently spotted some potential culprits, so legged it after them before talking to us and examining the house.
  • Without touching anything, I managed to piece together what had happened. The burglars – or, rather, a burglar – had crawled through the tiny window we keep open for the cats; I know this because it was completely fucked. Then he (and I use the male pronoun for a reason, which I’ll detail) saw the keys hanging up, opened the back door, and let his companion in.
  • They tried, I assume, to simply open the living room door – but, as we have done since the last burglary, we had locked it before leaving the house. They smashed the poor thing in with the Dyson, which was sitting in a corner of the kitchen. Unsurprisingly, they broke that too.
  • Entering the living room would have set the alarm off, and given all that they took and the bloody mess that they’d made, it was obvious that they knew the layout of the place. They couldn’t have got away with all that they did with the alarm (which itself calls the police) curbing their time had it been any other way.
  • They shoved the smaller items, which now seemed to include my old laptop, in bags, exited through the now-open back door, and onward through the gate at the back to the entry (which they’d also used the keys to unlock).
  • They hadn’t gone upstairs. Thank fuck I’d taken my current laptop up to the office; it was safe there. Curiously, they also hadn’t taken my Kindle. It was behind the door they’d smashed in, so perhaps they didn’t see it, or perhaps they didn’t identify it as a piece of expensive electronics because it was in its case, mimicking (to a point) a normal book.
  • Before we’d left, I’d deliberately moved the Kindle and A’s iPad out of view of the window. I neurotically checked the back door was locked about seven times, as I almost always do since the last break-in. Fat lot of good my caution did us.
  • The peelers returned. We were advised that they had taken two blokes into custody (hence my use of the male pronoun in reference to these criminals), and as I detailed my theory of their entrance to the female officer, her male colleague went to look around the back entry for further clues.
  • ….
  • …..
  • I am writing this post on A’s stolen iPad.
  • …..
  • ….
  • The policeman found everything out the back!
  • It seems that when the wankers were spotted, they unceremoniously dumped everything – or perhaps not quite everything? – and ran like fuck. But they were too late ūüôā
  • The police were here for quite a while. In short, they took statements, got the forensic people in and liaised back and forth with their station colleagues. The girl from forensics was extremely thorough – much more so than any of her colleagues we’ve previously met (bearing in mind that this is the fucking third time we’ve been burgled). Although she didn’t say much, it did appear that she had got some evidence from various things.
  • The male peeler had been around the entries of the surrounding area, and came across a small but slick, and quite evidently new, flat screen TV – in a bin. He reasonably enough supposed that it would be unlikely to have been chucked out by its owners, and thus brought it round here briefly for the forensics woman to dust. He and his colleague also revealed that other burglaries had been reported in the area that day.
  • As the cops were rounding things off, the bloke said, “just to check, you didn’t happen to have any wallets here, did you?” We responded in the negative. He nodded, but added, “any foreign currency, no?” It then occurred to me that yes – we did have a wallet in the house after all. We go to down to the Republic every so often, and there’s always leftover Euros. A has kept them in a wallet in the kitchen for months. I relayed this information to the cop as I went into the kitchen to see if it was there. It was not. The cop asked how much was in it. “At least ‚ā¨50, plus coins,” I told him. “There was a ‚ā¨50 note in it; I’m not sure if there were additional ones, but there was definitely a fifty.”
  • I watched with interest as the police exchanged satisfied glances. The wallet with the Euros had been found on the person of one of the personnel that their colleagues had in custody. A couldn’t contain his delight at this wonderful revelation; he jumped up and down screaming, “YES!!!” with the peelers standing there watching. In later conversation, the man said to me that he’s always thrilled in cases like this – both for the victims of the crime, and for officers themselves. “It’s always really nice when we manage to get a conviction,” he smiled. Indeed it must be. They don’t get very many of them for offences like this.
  • After they’d left, I ran down the street to a lovely lady, the only one in the whole area we’ve ever really spoken to, who’d offered us tea when she first realised what had happened. I wanted to let her know what had transpired, and also to apologise if we’d appeared ignorant in refusing said tea. That was weird, because I have never been in a neighbour’s house since I moved in with A, and have only ever exchanged pleasantries and cat-related anecdotes with this woman before. But I appreciated her kindness, and enjoyed the tea and cake that she was decent enough to serve me.
  • I came back and joined A in the clean-up operation. There was glass everywhere. There were strewn bags, clothes and other assorted pieces of fuck also everywhere.
  • Thankfully, the cats were both safe. Srto Gato was here when A got back, and sat down on the sofa, right in the middle of the carnage, and went to sleep. Mr Cat was, however, nowhere to be seen, and we both worried that, twisted as these fucks clearly are, they’d hurt him. H
    e turned up about about an hour after I got home, which was a relief, though he did seem unsettled all evening. Whether he merely sensed our moods, or whether he’d borne witness to some frightening events, we are of course unable to tell.
  • Another set of cops turned up after 10pm, when things had got vaguely back to normal. They had brought the wallet, the ‚ā¨50s and the various Euro coins in separate evidence bags for us to identify as ours. Needless to say, we confirmed that they indeed were. The bloke said as he was leaving that he had “no doubt” that the case would come to court, though he added drolly, “and then they’ll get their 25p fine and get back to their games.” He stressed, assuming as he erroneously did that we completely lacked any knowledge of legal infrastructure, that things were out of their hands then. People can be imprisoned in Norn Iron for burglary, but it’s rare. Even when it happens, custodial sentences tend to be pretty low.
  • The worst thing in the aftermath of all this was that the house wasn’t secure; a bollocksed window and a cunted internal door require supervision. The upshot of that is that I’ve had to stay here when A’s been at work. I don’t mind that, but it does inhibit our ability to live our normal lives. Determined to buy fags before Gideon’s shite budget whacked the price of the vile things up by 37p per packet, I ran out at lunchtime today. In the half hour or so that I was gone – I dropped into a few food-ish places as well – I was panicking, panicking, panicking that the little cunts were out on bail (as they almost certainly are by now) and would break-in again as revenge for our part in their apprehension.
  • On Monday, A rang an “emergency” glass fitter and then The Everythinger (to whom I alluded millaria above). The glass people came out later that day, removed the window from its frame and stuck a temporary board up in its stead. They said they’d be back on Tuesday to fix the window itself. They weren’t. They weren’t today either. They eventually contacted A to tell him that it’ll be at least tomorrow, as they’re waiting on hinges. What double fucking glazing company runs out of hinges?! “Emergency” my arse. At least The Everythinger, who was horrified to hear we’d been burgled only months after he was here the last time for the same reason, is coming tomorrow (later today, whatever it is).
  • Hilarious incidental. The peelers speculated that the theiving scum were on a drunken bender as they went about the area pilfering what they could. As such, they nicked beer from our kitchen. In fact, the one bottle that was open seemed to have been drunk out of, thus meaning potential evidence. Anyway, the burglars were clearly pissed off, as evidenced by their smashing of a few of the bottles and dumping of other ones. This, we’re all pretty sure, is because they had they discovered that they contained Becks Non-Alcoholic beers ūüėÄ Hahaha!

So, if it isn’t death, cancer scares, missing cats, depression, NHS cuntery (and the destruction of that already flawed system), a potentially impending financial desert (and the macro implications of that too), or other assorted nasties, it’s fucking burglary. Thanks, 2012. You’ve brought me the bleakest start to a new year that I can recall.

Yet, comparitively speaking, I’m OK, and thus must sound a note of optimism. Well, not optimism as such, but perhaps a little faith. Overall, I was extremely impressed with the Police Service of Northern Ireland on Sunday, and I was very touched that the lady from down the street had offered the basic but important kindness that she did. The hard work of the cops and the generosity of this sweet stranger reminded me that sometimes when you see the worst of humanity, you also see the best too.

Thank you to Mental Healthy, their judges, nominators and sponsors for their very kind short-listing of this blog for the 2011 Mental Health Heroes awards (in the ‘Creative – Writer’ category). It’s a big honour to be featured alongside such people as the wonderful Kayla Kavanagh, her partner and carer Nigel, and the lovely Fiona Art, so thank you again ūüôā

Anyone want to volunteer for TWIM or TNIM? You know you want to. Email me.

I can’t be arsed to proof-read this right now, sorry. It always mortifies me that my narratives could be error-laden, but I’m too tired to care as much as I should.

…And the NHS Cocks It Up Again

I had a psychiatric appointment on Wednesday morning. In terms of interaction with NewVCB regarding myself, it was fairly unremarkable. I apprised her of the various events that had occurred since I’d last seen her – Maisie’s death;¬†seeing Paedo;¬†the fact that the doctor’s bloody “surgery” screwed up my Lamictal script for several weeks; the kitten, Srto Gato, had temporarily (yet stressfully) disappeared (the latter two being stuff I’ve not ((yet)) discussed here); and that¬†I saw Paul again.

Essentially, although she had intended to decrease my dosage of Seroquel at this appointment, she decided against it because of the fuckery of the last few weeks. She wants me to get back on some sort of even keel that involves a minimum of external stressors before pissing about with the stuff, an assessment with which I agreed wholeheartedly. I said, “in light of particularly stressful events that previously occurred with various personnel from [Hotel California], I was very, very¬†glad to be taking anti-psychotics over the last few months.”

NewVCB understood. Although 400mg, the dose to which we are intending to reduce the Seroquel (at least in the short-term), had at one point prevented some of my psychotic symptoms, given that the last six weeks or so have been really shit, it would be ill advised to take any chances at the minute.

I did ask about increasing the Lamictal, however. I’m currently taking 100mg, and my internet readings have suggested the therapeutic dose is generally between 150 – 200mg. NewVCB disputed this, though; she said that 100mg is the usual standard in the (admittedly uncommon) circumstances in which she prescribes it.

“I’d prefer to keep it at 100mg for now,” she advised, “in part because you had a break in it enforced upon you, so it’ll take some time for you to entirely re-adjust to it. Thus it’ll take a few weeks to see its full effects again. Then, we can see.”

That seemed fair enough. In terms of the Seroquel, I said to her that I’d lost a lot of my appetite in the last, say, eight to 10 weeks, so at least in terms of weight gain, reducing the dose wasn’t as ‘urgent’ as it had once seemed. I told her that I’d read that Lamictal could sometimes cause weight loss, or at least a reduction in appetite, and she confirmed that this was indeed the case from time to time. She said she was pleased that this had been the case for me, not because she dared to opine that I had a plenitude of blubber surrounding all corners of my body (though clearly I do), but because she knew how annoying my weight gain had been for me especially when I’d been losing¬†so much of my pre-existing fat until I started taking 600mg of this heinous drug.

And that was pretty much that.

Except that it wasn’t.

“Um…now, Pandora, there’s, er, something I need to discuss with you,” she said ominously.

Oh my fucking God. She’s leaving.¬†Oh fuck! Fuck! Just when I thought things with the NHS were actually getting me somewhere!¬†The¬†incipient dread I felt as soon as each word of the sentence left her lips grew overwhelming very quickly.

“The NHS are changing things again,” NewVCB sighed.

Again?! [I can’t find any posts on this, aside from my review of my first appointment with NewVCB, but it was due to NHS changes that my consultant was changed from (Old)VCB to her in the first place, and that was only two years ago. What the fuck? More bureaucratic – and no doubt costly – bullshit from the fucking¬†NHS. What a sack of shite!].

She saw my face, and shot me a sympathetic glance. “I’m moving to [Big Scary Hospital],” she said. “Until recently, it was just assumed that I’d take all my patients from your GP’s surgery with me – but…God, this drives me to distraction! They’re re-drawing geographical boundaries, so right now I don’t know what’s going to happen. I may or may not be taking all such patients. I really have no idea at the minute.”

She was clearly frustrated by this fuckwank herself.

I drew a breath, then ventured, “Obviously – and I know you can’t do anything about it – I’d prefer to ‘stay with you’ if I possibly can.”

“I know. I know. I wish I could give you something more concrete at this stage, but I can’t unfortunately.” She shook her head and twisted her mouth in obvious vexation.

She continued by asking me exactly where my address was in the area, but although I could see her trying to mentally calculate whether or not the house was affected by the boundary change, she came up with nothing but a blank.

“When is this taking place?” I asked. “I mean, if I don’t move with you, will I see you again?”

“Oh, yes, yes – I’ll see you again in six weeks or so. This shouldn’t be happening until two to six months hence.”

I nodded, but something else occurred to me then. “Assuming for a minute that I do¬†move with you. What about Christine?”

“Well. In the long-term, they’re planning on moving the whole team – whatever ‘long-term’ means. But it certainly won’t be any time soon, so if you come with me, you’ll have to get another CPN.”

FUCK!

“And if I don’t go with you..?”

“Then you’ll still have Christine, here, but you’ll be moved to a new consultant.”

FUCK!

This is so fucking unfair. Just when things were going so well with my psychiatric team. Having both¬†a CPN and a consultant that you really like,¬†both¬†seeming to genuinely want to help you – that’s not at all common, especially in this bloody Health Service. And now, regardless of what happens, I’m going to lose 50% of that to a quantity entirely unknown. For all I know, the replacement for either the psychiatrist or the nurse could be fucking amazing – but my longer-term experience of the Psychiatric Service does not lend me to having a great deal of hope about that. Furthermore, even if the person were¬†brilliant, I’m happy with things as they are. I like¬†them! I like NewVCB and Christine! I want to stay with them both!

Don’t cuntwits like Mr Director-Person – who, as the head of mental health at the Trust, is at least partially responsible for this idiocy – realise that this kind of¬†upheaval is likely to only increase¬†illness, and therefore increase costs?¬†That, as a mental, it takes long enough to become settled with members of staff – and that breaking that confidence and trust is likely to lead to breakdowns, misery and crippling anxiety?

Well, of course Mr D-P doesn’t realise that. He doesn’t realise anything¬†about mental health, because he’s nothing more than a general manager, and always has been – he comes from a business-y private sector perspective, that isn’t even remotely tangential to mentalism.¬†So no, despite all the fucking risk assessments they’ve no doubt claimed to have undertaken, he and his cronies have no idea what it’s like on the fucking ground, in the fucking real world, of someone with (a) mental health condition(s). It’s alright for him to sit in his inviolable ivory tower of an office, and play about with geographical lines on a computer (or, more likely, ‘getting his secretary to play about with geographical lines on a computer’ whilst he plays that little mini-golf game you always see¬†executives¬†figuratively masturbating over). It’s not alright when the ramifications of that feed back down to patients who are, as a direct result, going to suffer like fuck.

And nobody can do a damn thing about it. Fuck the Trust. I can’t for the life of me work out what it is¬†that they care about, but it certainly¬†isn’t their patients ‘service users’. Bastards.

Absolutely Damn All Squared

I’m still in the land of the living. Or the existing, as you prefer. I know I haven’t written anything in what seems (for me) like ages, but there’s not a great deal to report.

I had written an entire post and when I went to upload it, my WP application crashed. So I won’t bother to recreate it; I’ll just make the basic points I was initially going to.

One: voting is still open, until midday next Saturday, in the TWIM awards; just click here. Thank you to those of you that voted for me, thank you: I genuinely appreciate it. However, in the interests of impartiality, I’ve disqualified myself so the votes won’t count – but thank you anyhow. I still don’t understand why you read or like this blog. But that you do genuinely touches me, so thank you.

Two: I probably won’t be writing here much until at least January; I’ll try to do my traditional “what happened this year” round-up, but I won’t promise. For one thing, I’m very stressed (and also disproportionately upset – I so need to get a fucking life) about something I can’t (at least yet) discuss here. More importantly, I have a major piece of professional writing deadlined for 2nd January, and of course that will take priority over my usual garbling bollocks for here. So I have, for once, a genuine reason not to crap on on Confessions, rather than my failure to post being attributable to anhedonia, avolition or laziness (though I must admit to the presence of the former two nevertheless).

Also, please note that I will not be doing anything TWIM-related until at least Tuesday. I’m even temporarily removing the relevant email account from my phone!

I haven’t been on Twitter for days (other than to tweet the odd article via third party apps, or to text a random observation or something), and probably won’t be for…well, some more days. If you’ve @mentioned or DMed me, I’m honestly not ignoring you and will catch up before too long ūüôā

Three: after seeing NewVCB on Wednesday, I am now taking 100mg of Lamotrigine. Unfortunately 50mg of this is in the morning, which doesn’t sit especially well with my daily Seroquel hangovers. On the latter, by the way, I am going to be a fat bitch for a good bit longer than anticipated because she NewVCB wants to increase my Lamotrigine dosage again in the new year, and isn’t keen on modifying two medications at the same time (which is fair enough).

Four: A and I are at my mother’s; we’ll spend Shitmas Day here, and then head to A’s father and step-mother’s house for Cocksing Day. It is a good way to spend Christmas, insofar as that’s ever possible, because it’s so delightfully fucking quiet . A pity about the cunt TV, but you can’t have everything I suppose.

Five: the important one. I may hate this time of year, but it doesn’t stop me from hoping that you don’t. For those of you that celebrate Christmas, have a very happy one. For non-Christians celebrating concurrent festivals, I’m sending equally good wishes to you too. In case I’m not here again before January, I’ll also take this opportunity to wish you a very happy, healthy and prosperous 2012.

I don’t say it enough, but I sincerely appreciate every one of you. Thanks for your unending support and friendship. I do love you.

Be safe everyone, and take care.

Love

Pan

Initial Side Effects of Lamictal…and a Long Overdue Rant

If you follow me on Twitter, you may have been the unfortunate recipient of a number of tweets yesterday evening that contained almost epic levels of ranting. I had written an entire post for this blog on A’s iPad, which, whilst better for typing than our iPhones, is not as conducive to creating lengthy prosaic lamentations as a proper keyboard. Unfortunately for me, I’m in my laptop-phobia zone this week, and to that end only the iPad and the iPhone are safe for use (don’t ask for an explanation of this fatuity, because I don’t have one. Maybe I’ve simply grown to hate Windross so much that I fear even seeing it. Time to put Debian on the laptop, perchance).

Anyhow, I was a complete moron and decided to use the Blogpress iOS app to aid me in this ignoble endeavour. Just as I had finished, with the usual laughably stupid length of post completed, and went to save the entry – the cunting, fucking, shitting bastard of an application died on me. I lost every single word. I tried all the usual wank in an attempt to save it – close the app, turn device off and back on, etc – but circa 2,000 words and just over an hour of my time were lost to the dark realms of the e-ther (geddit?!) and try as I might to continue the rescue effort, the bloody thing just crashed, crashed and crashed a-fucking-gain. Shitting fuckery hell and bollocks.

So, iOS V users – don’t use Blogpress, OK? Not, at least, it’s been thoroughly updated and tested. It used to be a great wee app – it is, ostensibly, a much more fully featured blogging program than WordPress’s own. But at least (eventually) the latter fucking works. So that is where I find myself as I type this attempt at a re-write.

First though…

JESUS FUCKING CHRIST BUT I AM SO ANGRY. THE POST WAS ACTUALLY NOT BAD, UNLIKE FUCKING EVERYTHING I’VE WRITTEN FOR MONTHS. I WOULD HAVE BEEN FUCKING CUNTED THE FUCK OFF IF THE BASTARDING PIECE OF FUCKWITTAGE LOST A MORE CHARACTERISTIC LOAD OF FUCKING SHITEY CUNTFLAPPED BELLENDERY, BUT THE FACT IT LOST SOMETHING VAGUELY NOT COMPLETELY BLOODY AWFUL MAKES ME WANT TO SMASH THE LIVING BECHRIST OUT OF EVERYTHING. YOU CAN NEVER BASTARDING WELL REWRITE SOMETHING TOLERABLY BLOODY PASSABLE TO THE SAME PSEUDO-ALRIGHT LEVEL AS IT WAS THE FIRST SHITHEAD OF A TIME YOU FIRST BLOODY WROTE THE BOLLOCKFIST OF A FUCKING THING, SO WHAT FOLLOWS HERE WILL BE BACK TO MY USUAL DICKHEAD STANDARD OF UTTER COCK. FUCK TO THE ENDS OF ALL THE KNOWN BALLWIPED DIMENSIONS. FUCK. FUCK. FUCK.

Well, it’s been a while since there was a proper rant here, hasn’t it? And lo, I used to be the Queen of Rants in the Madosophere. But anyway, now that we’ve got that out of the way…

I’m having some difficulty adjusting to Lamictal. Don’t worry, if you’re one of those odd people that may in some way give a flying arse about my existence, there’s no “FUCK I’M DYING” rash or anything. But the drug has brought me an insane level of fatigue (for example, I nearly fell asleep yesterday afternoon whilst playing Saints Row: The Third, which had delightfully arrived here early. I mean seriously, what the actual fuck? No one with even five per cent of a pulse falls asleep whilst playing Saints fucking Row!!!), my eyes have gone cross-eyed, my levels of forgetfulness that began with Venlafaxine (curse it) are amplified to objectively hilarious points of pseudo-dementia (cf. in people’s company a few days ago: “A, what’s my name again? Oh yeah. And, old chap, should you be so obliging as to advise me on the word one uses to intimate the device used to take a crap? Yes! ‘Toilet’. That’s it.”) and my regular migraine-level headaches are now even more frequent. The last point is especially irritating as, in off-label indications at least, Lamictal is used to treat headaches. Go figure, eh?

The exhaustion is not simply that frustrating but familiar kind of languorous weariness to which we are all often slaves – oh no, this is hardcore stuff, even by my own insomniac standards. It’s that kind of exhaustion that is like an gaping vault of oppressive darkness, sucking you in, dominating you entirely, screwing with your mind until it hurts but rendering you useless to do anything about it. It’s that kind of interminable, preponderant bleak tiredness normally wedded to the very worst of depressions – you know the ones I mean. That old familiar hangdog horror in which rising from your bed is not just a difficulty, but an impossibility. The old foe that leaves you helplessly staring at the wall, willing it with whatever mental faculties you have remaining to somehow show you some mercy and let you die. The old knocking on the door of the mind that reminds you that you have no escape, because you are utterly devoid of enough motivation to even end things yourself. The old living hell that seems unresolvable.

Normally such exhaustion and a depressive hell are thus united – but not in this case. It would be a lie to say that the tiredness does not impact upon my mood in some fashion, but for someone whose mental agility and body alike are so heavily enervated, I actually feel pretty stable in this regard. Indeed, Null thinks I’m high. As I was trying to write the original of this post last night (RIP), I must confess that I did wonder that myself; the style of my prose, whilst slightly better than my shitty norm, did have something of a manic quality to it (perhaps that’s exactly why it was slightly less rubbish than as is typical!).

Allow me to exemplify how OK I am, despite Lamictal’s nefarious side effects. I have exactly ¬£1.06 to my name right now, and even that’s part of my overdraft – yet I am not panicking like an old lady denied her copy of her all-important Bella magazine like I normally would; instead, I’m tolerably riding the wave of patience until I get paid next week. It’s November, and I don’t want to run out and throw myself off the nearest bridge or towerblock. Indeed, even bastarding, fuckwitted, hateful, cunting Shitmas has been surprisingly kind to me this year: the hackneyed and improbably dainty ads for the accursed capitalist nonsense only began registering on my radar about six weeks in advance of 25 December, rather than the 12 or 13 weeks to which I am normally frustratingly used. And, next week, off I go to London, where I am short-listed for a Mind Media Award. I am excited, rather than entirely petrified, by this. I mean, of course I should be excited – but as someone with social anxiety issues which are, at times, very severe, it’s a surprisingly gratifying thing that being faced with being in such a busy venue with – dun-dun-DUN! – famous people does not scare the living bejesus out of me right now.

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Lest anyone think I’m in the midst of a narcissistic delusion of grandeur regarding the awards ceremony, no, I do not – not for half a second – entertain the notion that I could possibly win the award. No way. But it doesn’t matter; what matters is being there. It is enough to have the opportunity to meet some incredibly interesting and highly influential individuals operating in the arena of mental health; it is enough that someone, somewhere has considered this silly blog even worthy of mentioning in the same breath as some truly excellent anti-stigma and exploratory material; it is enough that I dare to see my name listed in honour of the late Mark Hanson, a stalwart of the social media world who suffered from horrendous depression; and it is enough that I have the opportunity to see some of my wonderful old friends and, indeed, to meet one of my oldest and most supportive online friends for the first time (so excited, bourach! :D). Although it would be beyond absolutely incredible to win, to be in the position I already am is more than enough.

So, although I’m fighting medication side effects from every angle, I’m doing relatively well. As for the side effects themselves – well, according to most of the literature on Lamictal, they will pass. Indeed, I already feel them abate, ever so slightly. As the days pass, my eyes will blur things a little less, my energy levels will increase a little more, and my headaches will revert to the mediocre but liveable standards to which I’ve long been accustomed. Maybe the current drug cocktail will, in the end, work for me after all.

What’s that you say, fair reader? “Oh dear God, Pan’s defining characteristic of cynicism has been lost?” No, fear not – I have not become so washed away by some sort of bright absolution that I have become an optimist. Christmas still sucks, the world is still a cunthole, I’m still an infernal misanthrope and I still can’t stand the sight of happy couples frolicking around the shops like some sort of silly vapid bunnies. I’m just a misanthrope that can’t stand the sight of happy couples frolicking around the shops like some sort of silly vapid bunnies who happens not to feel opprobriously atrocious for once.

If you don’t like that…suck it up ūüėČ

(NB. I haven’t proof-read the above folks, sorry. I humbly beg your forgiveness for any poor turn of phrase, grammar, spelling etc, and I shall endeavour to correct such issues at my next available opportunity. Toodle-pip!).

Livin' La Vida Lamictal

Good afternoon my beauties.

Yes, I remain on this plane of existence. I simply have no idea what to write here – well, actually, that isn’t true; I have quite a few ideas floating around in my head, but in terms of actually recording them on this blog, I’ve failed to do anything with them. Never mind. Maybe next week I will feel more amenable to blogging? I have one piece of (unpaid but) professional writing to get done which will take priority, but perhaps the mere act of getting some words out of my system will help motivate me into putting more here.

I don’t know where this apathy has come from; I want¬†to write, but I just cannot work up some sort of inclination to do so. I’m not particularly depressed in the traditional mood sense, and in fact have at times found myself quite hyper of late, but this week has been a frustratingly busy one and let’s not forget that it’s November – a month that¬†I detest. How the fuck¬†did it get to be November? My life is passing me quickly by in a haze of malaise and anhedonia, and it reminds me acutely of how much I’ve wasted my fucking 20s and failed to achieve anything of any notable worth.

Still, this was not meant to be a post in which I complain about my failure at life; there’s plenty of material there for another post entirely! Instead, let’s have a brief, dull look at my appointment on Wednesday with my consultant psychiatrist, NewVCB.

Incidentally, I feel guilty for continuing to apply the moniker of ‘NewVCB’ to the woman, because it was borne out of my distrust and dislike for her predecessor and the implicit hatred does not apply to NewVCB. Let me use this as a disclaimer, then: I do not¬†think that NewVCB is a vingear cunted bitch. I actuall quite like her. Nevertheless, that has become the term by which people are used to knowing her, so I will maintain it for that reason alone.

She was running late on Wednesday, which is fairly unusual for her. I was mildly irked – not at her specifically, but more at her previous patients for taking up her time – because, carless as I was at the time, I’d had to get a combination of a taxi and a bus to get to the outbin, and had unnecessarily rushed like blazes. Waiting for her produced further frustration in the form of an¬†elderly¬†couple making whispered¬†judgements¬†on other patients wandering in and out of the building.

“Anorexia,” the man murmured, nodding to a girl walking out the main door.

“No, no,” replied the woman. “That girl looks haggard. Some form of anxiety, I think. Nothing too serious.”

What the fuck?! Firstly, what gives these two wankers the right to talk about personal issues pertaining to other patients? Secondly, anorexia and anxiety frequently co-occur, do they not, and either way, is it any surprise that the girl looked “haggard”? Many mentals do! And three – how the fuck¬†can anxiety not be “too serious”? Many forms of anxiety can be fucking life-threatening!

Grr. Normally I love elderly people but these two old gits thoroughly deserved a slap. Anyway, their presumptuous pseudo-speculation was cut mercifully short by NewVCB Рbut she was there for the two of them at that juncture, and not for me. Ballbags. I sought refuge on Twitter, as usual moaning about the nature of the situation.

Shortly thereafter, my mother appeared. She was collecting me from the outbin owning to the absence of my beautiful car, which was with the mechanic in preparation for his MOT. Mum assumed I was in the waiting room waiting for her, rather than NewVCB and was annoyed to find that she, too, would now have to wait. Sigh. As√≠ es la vida, ¬Ņno?

Anyhow, when I eventually did see her, I couldn’t have been in with her for more than 10 minutes. I told her a highly redacted version of my recent possible episode of hypomania. Christine, my CPN, had advised me that she would discuss the issue with NewVCB in advance of this appointment, and it must have indeed been the case because despite my discussion of it lasting little more than 30 seconds, she said, “it does sound like a period of elation.”

My brow furrowed slightly, so she continued, “well, you know what I mean; yeah, I understand that with it came¬†irritation¬†and uncomfortable racing thoughts, but nevertheless…”

I nodded, seeing what she meant.

She went on to say that she was very conscious of my dosage of Venlafaxine being pretty high. As she noted, she has no problem with my continuing on said dose, but thinks it is something which “we need to keep an eye on.” This kind of confirmed to me that she is now definitely thinking that I have some form of manic depression, though I didn’t ask her directly as I had intended to do. The thing is, she’s never even thought twice about how much Venlafaxine I take in the past, so this seemed significant. Venlafaxine is, of course (in common with SSRIs and other SNRIs), capable of inducing manic or hypomanic behaviour in susceptible individuals.

To be honest, I’ve been taking 300mg for so long without any madness of this particular flavour that I genuinely doubt it’s related, but that said, it is reasonable and sensible to monitor it nonetheless.

Anyhow, I reminded her that the last time we’d met we had discussed reducing my daily intake of Seroquel because of the preposterous amount of weight 600mg of it has caused me to gain. At that appointment, NewVCB had suggested that I continue to take the Seroquel at a reduced dose (to maintain its anti-psychotic properties) and then, to mitigate the loss of its mood-stabilising effects, add in…well, a mood stabiliser. You may recall at that appointment she had alluded to Lithium and Depakote, but the excellent discussion in the comments of the relevant post had put me off them somewhat (particularly the latter). Furthermore, a number of you asked in that thread (and elsewhere) if Lamotrigine (AKA Lamictal) would not be better for me, as although it is used in the general maintenance of bipolar disorder, it is considered particularly good for depression.

I therefore told NewVCB that I had been researching the drug, and that I’d like to try it. “Despite that episode last week,” I told her, “as you know, my symptoms are primarily depressive – so Lamotrigine seems, to me at least, like a good call. What do you think?”

She sort of waved her arms about in a gesture of agreement. “Yes, it is¬†especially good for depression, so yeah, I have absolutely no problem prescribing that for you,” she replied. “My ideal combination for you would be sodium valproate [Depakote] along with the Venlafaxine, but as I told you…well, it’s not considered ideal for women of your age.” She looked up sort of sheepishly at me. I think she was non-verbally intimating to me that she understood my decision to remain childfree, but that that might not go down terribly well with other whitecoats and fuckwit-managerial types that might find out about it.

For different reasons, this suits me perfectly well. I was horribly put off Depakote by some of my readers’ experiences with it – for example, I think it was tai that said in the afore-linked comments that she gained a lot¬†of weight whilst taking this medication. Since that is precisely¬†the reason I wish to reduce my intake of Seroquel, which has otherwise been a wonderfully successful drug for me, moving to Depakote with its potential weight issues would complete miss the point!

So, she got out her prescription pad, consulted her medication guidebook, and scribbled out a script for the Lamictal for me. I am to take 25mg daily for a fortnight, then move up to 50mg until I next see her (in about six weeks, she says, which should give the new stuff some time to start working). She said that she wanted to maintain the Seroquel at 600mg for now until the Lamictal has built up in my system, but that she’ll whack it down to 400mg the next time I see her (assuming the Lamictal seems to be working, of course).

I got the inevitable but important warning about the dreaded Lamictal rash, but that was pretty much it, and off I trotted to my GPs’ practice to hand in the script.

One thing I completely forgot to mention to NewVCB was that I take the contraceptive mini-pill. A little bit of research has suggested that since this pill is proestrogen only, that it and the Lamictal should not interact. Apparently, Lamictal can reduce the effects of the normal, ie. oestrogen, pill¬†– and said pill can, in turn, reduce the effects of the Lamictal! It does not¬†seem to be an issue with the minipill, but I’ve put on an appointment with Lovely GP just to check. In the meantime, if any of you have any information about this, I’d be very grateful to hear about it ūüôā

Shockingly, Fat Pharmacist did have my new prescription when I went to get it yesterday afternoon (of course, he didn’t have the Seroquel, Venlafaxine, Cetirizine and Zopiclone that I had requested, but why quibble about such mere niceties with the useless ginger twat? It is only my fucking health we’re concerned with here, after all…), so I took the first dose of it last night. I took a Zopiclone just in case I’d draw the predictable straw of insomnia that can potentially come with the stuff, and I was squinting a wee bit more than normal when I went to the shop (another potential side effect), but overall nothing seemed amiss – though, to be fair, it’s a bit early to tell.

So. I currently take the following medications:

  • Venlafaxine/Effexor, 300mg daily
  • Quetiapine/Seroquel, 600mg daily
  • Lamotrigine/Lamictal, 25mg daily (to be raised)
  • Cetirizine, 10 mg daily
  • Cerazette, 75 mg daily
  • Multi-vitamin, whatever-it-may-be daily
  • Zopiclone, 7.5mg as needed
  • Diazepam/Valium, 5 – 15mg as needed

Jesus fucking Christ. At this rate I could be a drug dealer. Still, I’m feeling positive about the new introduction to my daily¬†pharmaceutical¬†routine, and about losing some bloody weight when the Seroquel is reduced. But we’ll just have to wait and see.

Anyhow, I’ll try and write on those issues wafting around in my head in the next week or so. Have a great weekend in the meantime, lovely people.

(I’m in a rush so can’t be arsed proof-reading this. Sorry for the probable multitude of errors herein).

Hypomanic Hogwash (and Seeing the CPN)

Having finished my posts on the first stint of therapy that I had with Paul, I’ve been left feeling surprisingly disenfranchised as regards my writing here. By that I mean that I have no idea whatsoever about what I should write. I mean, when I hadn’t finished the stuff on Paul, I procrastinated and procrastinated, and avoided having to tackle those posts by thinking of other inane stuff to throw at these pages. Now, in stark contrast, I can think of nothing. This is what might be known as a ‘fail’.

So, then. Let’s go with an obligatory ‘I had an appointment’ post. This one was with Christine, my CPN, on Tuesday.

The weekend had been an odd one. If you follow me on Twitter, on Friday night you might have seen why. I was behaving in a completely out-of-character fashion: gushing about how much I loved everyone, ravingly extolling the virtues of random Babylon 5 YouTube videos to people whose names I failed to correctly spell, wittering on (admittedly with my tongue firmly planted in my cheek) about how fucking awesome I supposedly was, asking people to participate in C(o)untdown contests (what the fuck?!) and generally going about screaming (or whatever the equivalent is on Twitter) “WAH!” and “WOOOOO!” and suchlike. What. A. Freak.

Saturday was better, but marginally so. The in-laws, who are selling their house, were throwing a party – ostensibly for no reason, but it felt like a ‘goodbye to Nice House in Shite Town’ kind of event (though, that said, as far as I know there have been no offers or any meaningful inquiries about the sale). Anyway, after visiting A’s father and step-mother who live relatively close to his mother and step-father, off we headed to the abode of the latter. And, although I was conscious enough of how mental I’d been behaving on Friday night and sought to curb the obvious signs of same on Saturday, I generally behaved like a twat then too. My sister-in-law, very drunk at one stage, welcomed what she appeared to see as my enthusiasm (ha!), as my mother-in-law seemed to do also. My own mother, however, was less impressed. (I forget the expression she used, but it was probably something along the lines of “catch yourself on,” a Northern Irish colloquialism that I have always loathed due to the unavoidable fact that it makes absolutely no sense in terms of syntax).

At one point my mother particularly riled me by throwing a blithe back-handed insult in my general direction. I can’t be arsed to go into the specifics, but Clarissa has cogently written about her own mother’s infuriatingly similar behaviour here, so read that if you want to get a feel for what I’m on about. This remark ignited an underlying irritability, masked by my ostensibly great mood, and I called Mum up on it, but of course we ended up getting sucked into the usual pointless circle of blame: “I’m always to blame”, “No, I’m always to blame,” yadda yadda yadda. So rather than fight it out with her, I sat down silently beside her, then suddenly started telling her why Anthony Burgess had decided to write A Clockwork Orange. My mother eyed me with bewildered suspicion, and after listening to 10 minutes of myself rabbiting on, I felt compelled to join her. A Clockwork Orange is an incredible book – one of my favourites ever written – but seriously, what the fuck? My pseudo-scholarly analysis of the background leading up to it was one of the best examples of a personally acted-out randomness that I can remember since my school days with Daniel (one such recollection: my mother was out at golf one evening, so Daniel and I ended up playing the fools by wearing cushions on our head, grabbing an abandoned curtain pole, and running up and down the quiet street squeaking, “weeeeeeeeeeeeeee! WEEEEEEEEEEEEEE!”, all whilst each holding one side of the pole. And that’s just one such example).

So yeah. I was mad. Someone’s going to come on here and ask if I had been drinking; well, that’s in the affirmative, but honestly – this was notlunacy fueled by alcohol consumption. If anything, knowing things were a bit weird, I was more measured in my imbibing that I otherwise might have been. And alcohol, even mixed with the current medications that I take, has not in and of itself ever affected me like this. Other people’s mileage may vary, but that is mine.

On Sunday and Monday, although I behaved apparently fairly normally, my brain was certainly hyper, and thoughts seemed to race through it faster than the speed of light. Until Monday evening, that is, when I promptly and suddenly fell about 80,000 figurative parsecs, and was paralysed by a deep – but mercifully brief – depression.

Essentially, the above tale characterised my meeting with Christine on Tuesday morning. She asked a lot of questions about my behaviour and mentality over the weekend, to the point where I was beginning to wonder if I was in some sort of bizarre Capgras situation wherein she’d been replaced by a GCHQ operative quizzing me about whatever act of criminality or terrorism they might like to pin on me (not really, by the way. That was a demonstrative hyperbole, not my actual thought process):

  • Had I been irritable (yes)
  • Had I been sleeping normally (no – if ‘normally’ means well, that is)
  • Had I slept at all (not to any meaningful extent – a couple of hours here and there maybe, were I blessed with a lucky night)
  • But had I not needed any extra sleep (apparently not – highly unusual)
  • What had my energy levels been like (jumping around the place like a twatting hyena on crack)
  • Had I dominated conversation (it varied from person to person, but in most cases I must have seemed like a self-obsessed bastardface – so yes)
  • Was I able to curb any compulsion to talk (no, fucking babbled endlessly on about every piece of meaningless minutiae pertaining to any given subject)
  • Had I been afflicted with racing thoughts (yes, to the point where it felt like a cognitive kaleidoscope was exploding over and over and over again in my head)

You get the picture. She had started her analysis by saying that it may be difficult to distinguish whether this wankery had been a simple good mood or an episode of hypomania, but as I answered the questions put to me one by sorry one, she noddingly came to the conclusion that it was, in all probability, the latter.

The distinction is one I find hard to make myself especially as, as Christine noted, a genuine good mood is a very, very rare thing in my life. On this occasion, however, my behaviour had been so horribly out of character that I had to agree with her final assessment: I was probably mental.

I got myself into quite a tizzy about it. Firstly, I tried to claim that it could not have been a hypomanic episode, because it only lasted a few days. She refuted that, stating predictably and reasonably enough that there was great variance in the duration of such moods across everyone afflicted by them.

OK then, but the last time I remember being hypomanic to any notable degree was – fuck me, it must have been 18 months or more ago. (There have been very minor instances of it since, in the sense that they’ve only lasted for one evening – and, curiously, seem to be the exclusive…er…privilege (ha) of my visually impaired friends. I cannot stop talking when I see them, and I’m restless and jump about and make too much noise and pace and flit from topic A to topic B to topic fucking Z). I’ve certainly had what I believe to be mixed episodes in that time – those have been a sorry staple of my life for quite a few years now, though I only realised they had a name after I started writing this blog – but hypomania has been relatively and curiously elusive (and, indeed, its big brother – the full-blown euphoric mania – has been more or less non-existent).

Given the good mood that accompanies episodes like this, I was, on Twitter, heard (seen?) to express a murmur of regret about the paucity of them in my life. However, La-Reve promptly and correctly reminded me that hypomania – whilst better than actual mania (which she has experienced, even if I haven’t) – is actually rather shit. This is true, for two key reasons. One: the higher you are, the lower you fall. Two: actions have consequences.

By the latter point, I mean that, when I had calmed down, I was absolutely and completely fucking affronted by my behaviour. I am not like that. I am known in certain company, that of my in-laws for example, as someone who enjoys a laugh and a bit of craic – but not as someone who jumps around elated, squealing in wide-eyed delight because someone suggested putting a fucking CD into the presiding hi-fi. I am, I hope, known on Twitter as someone who really does care about the people with whom she’s developed genuine friendships – but (I hope) not as someone who wastes bandwidth CAPITALISING EVERYTHING SHE FUCKING TYPES TO TRY TO MAKE THE POINT THAT SHE LOVES EVERYONE SHE’S EVER SPOKEN TO (BECAUSE, WHEEEEE, ISN’T SHE JUST SUCH AN AWESOME PERSON) EVEN MORE CLEARLY THAN SHE ALREADY HAD (or, in greater likelihood, quite the opposite).

So yes, I was (and am) embarrassed, and I told Christine so. She shrugged it off a little; whilst she feels that this was a hypomanic intrusion, she also thinks that I behaved as some more extroverted people might generally act as standard. The assertion irritated me slightly; it is, indubitably, true – but it is not true for me. If I were a natural extrovert, laden heavy with an arrogance that blinded me, then of course it wouldn’t matter – but I’m not. I’m me, and the person I was last weekend didn’t correspond to my self-perceptions at all. Other people’s norms do not matter in this equation.

Christine asked me when I was next seeing NewVCB, and I responded by stating that it was next week (Wednesday, I think). She appeared glad to hear this, and asked me if I was still OK with possibly going down the mood stabiliser path. I confirmed that I was, especially in light of all this shite. She acknowledged that she had some concern in that regard too.

We talked about Lithium versus Lamotragine. Reading between the lines, she seems to favour the former, but my preference is distinctly for the latter. Despite the contents of this post, as most of you will be aware, my symptoms – if I even have a form of manic depression at all – are very predominantly depressive. Secondarily, I’ve heard of people putting on weight on Lithium – and since that’s the primary reason that I want to reduce my Seroquel intake, it feels like taking it to mitigate Seroquel’s lost mood-altering effects could be a false economy. Lamotrogine, by contrast, seems to carry a greatly reduced risk of weight gain; indeed, I’ve read that in some cases it actually seems to reduce the bulge.

Not that I’m unwilling to experiment, mind you. It’s just that my first preference is for Lamotragine – if, for whatever reason, that fails to function as I hope, then I’d be ready to at least try Lithium.

At my mention of depression, Christine asked had that more generally characterised my mood since I’d last seen her. The answer to this was ‘not really’ – but, when a greater timeframe is applied to the question, it would have to become ‘yes’. In June, say, I was feeling pretty positive, and felt that my outstretched fingers were within mere inches of grasping the branch that is recovery. Now, although I don’t feel hideously awful, that former optimism has become a shattered reality, unobtainable and out of reach.

I exemplified it to her thus. A has observed over the last four or five months that things with me have been on a slow but definite downwards slope; apparently, at increasingly frequent intervals, I have exhibited a general aura of malaise and despondency, I have all but completely lost interest in leaving the house alone, and I’m really avoiding things that have traditionally given me pleasure. Although of course A cannot be said to be entirely objective – he is, after all, emotionally invested in me and my well-being – he sees things without the internal bias that the mind of a mental (or of anyone, in relation to themselves) inevitably creates. I might have said that I was plodding along with relative ease; his testimony highlights a more truthful version of reality.

Christine said that she would discuss what came up in our appointment with NewVCB before my meeting with the latter. She went on to ask about psychosis (nothing much), dissociation (nul points) and then, to my consternation, therapy. It wasn’t her fault that I was slightly dismayed – it’s Nexus’. I reapplied to see Paul again about five weeks ago, and although they confirmed I’d go back on his waiting list, I’ve heard absolutely nothing from them since. This is, as you might imagine, frustrating.

Christine asked if it were possible that my decline in spirits was related to the absence of therapy. Although I believe that I have melancholic (as opposed to reactive) depressive moods, it would be churlish of me not to entertain this as at least a possibility. Indeed, I think A has noticed a slight correlation, and I told her so.

It was therefore agreed that if I haven’t heard from Nexus by the end of this week (ie. tomorrow, since I’ve heard fuck all in the time between seeing Christine and now), that I would send a polite and brief follow-up email asking what the craic was. I kind of feel uncomfortable about doing so, as it seems to me that I’m making demands on the charity’s time – but in rational terms, I suppose a quick email is hardly the work of a servant of Satan. At the end of the day, I’d rather know what was going on than not.

The session (with Christine) drew to a close with a conversation about the awards ceremony, and my going to London at the end of the month in general. I shared with her that although this crappy blog being short-listed for something so prestigious, something so fucking big, is an honour of the like I cannot adequately hope to express, that I have a certain amount of anxiety about the ceremony itself. It’s a big deal; there will be a lot of people there, and many of them are household names (that said, that will probably mean damn all to A and me. We know nothing about most celebrity types). Let’s not forget that I have social anxiety on top of everything else!

She amiably and empathetically acknowledged this issue. “But,” she added, “you have as much right to be there as they do!”

Well, because of the appalling taste* of the short-listers, apparently I do ūüėČ [* Comment applies to this entry alone, and not the other four in my category, nor nominees in other categories either. The short-listers have great taste in some of those!]. I mean, yeah, I’m nervous – how could I not be? – but although I honestly don’t think I have a cat’s chance in hell of winning anything, I still see much opportunity in going to the event. So I’ll be shitting a brick, but I’m still excited.

Also, I seem to have organised a fuck of a lot of things during our sojourn, meaning that I’m not actually 100% sure if I can ‘do’ a mini-Mad Up or not ūüė¶ I’m finally meeting the wonderful bourach for the first time, I’m seeing my best mate Daniel, plus another lovely friend, CVM – and, when you take the ceremony into consideration, that leaves me with very little free time. Christine provided wise counsel on this; it is not a good idea to over-exert myself on the trip, especially when I’ll probably be an anxiety-ridden mess anyway. I’m not completely ruling it out, you understand, and even if I am, I’ll be back in England’s green and pleasant land in the not-too-distant future anyway. Let us see, yes? Please forgive me in advance, if it doesn’t happen? *begs like a puppy*

Christine and I parted after arranging another appointment just before A and I head off to the mainland. To her credit, she realises the magnitude in my life of this trip, and accordingly wants to offer extra support where she can. Not everything about NHS mental health services is completely shit.

Anyway, things are mostly back to normal here. I’m aggrieved that I’ve had so little time to hermit this week because of the aforementioned appointment, having to get new tyres on the car and, tomorrow, having to take the car to my mechanic in preparation for his MOT (‘his’ in that clause is not a typo. I do anthropomorphise my car). Next week is even worse, and I crave solitude and social tolerance of my agoraphobia. But I don’t seem to be even remotely manic, which is good, and I’m not overtly particularly depressed, which is even better.

If you notice anything out of the ordinary on Twitter this weekend, I want you all to beat me with a big stick. OK? OK. Good.

Good night, lovers. ‚̧ xxx

Change of Diagnosis

I finally saw my CPN, Christine, this morning. I say ‘finally’ as I had been meant to see her about – what? A month ago? Three weeks past? Something like that. I turned up on that occasion, early as usual, and reported to the CMHT/outpatients reception in the normal fashion. The bloke seemed a bit unsettled to see me, which should have been a warning sign that things were afoot, but then he told me to have a seat, as normal, in the waiting room. I dutifully did so.

And thus began the wait for which the term ‘waiting room’ was invented. To be honest, as soon as the allocated appointment time had been and gone, I somehow knew that she wasn’t coming – but rather than approach the reception bloke again and enquire as to Christine’s status on this plane, I just sat there rocking back and forth like the oversized bodybag of insanity that I am. Someone sat opposite me, curled up in her seat in a ball. Someone else sat to my right, shuddering and ‘ticcing’ with a remarkable frequency, as if afflicted by tardive dyskinesia (not such an improbable scenario in this realm, of course). I was struck by the obvious mental illnesses of all three of us: you might think that comes as no surprise in a psychiatric outpatients waiting room, but you’d be wrong.

In my two-plus years of attending the outbin, I’ve always been a little taken aback by how completely sane and normal most of the people looked – and then this makes me feel like a right stigmatising bitch. Mental health problems really aren’t that abnormal, and societal stereotypes on how people with such issues should look (foaming at the mouth, constantly existing in states of 1,000 yard-staring catatonia, running around wielding knives) are dated, inaccurate and sickeningly discriminatory. Madness can affect anyone – any age, any race, any gender, any religion, any sexuality, any class. It does not discriminate, and it can be well disguised. So why would I, someone who should have known better, have assumed that there must be a certain ‘look’ a mental must have, or particular behaviours he or she must present? Why does the the complete ordinariness of most mental health outpatients surprise me so? Because I’m a bigoted bitch, no better than the majority of the supposedly sane community who generally live in a similar ignorance – that’s why.

But I digress, as I am often wont to do. I knew Christine wasn’t going to turn up on this occasion because of the confluence of events in which (a) reception bloke had regarded me with an odd disposition; and (b) there had been a missed call from an unknown number on my phone earlier that day. No one had left a fucking message, though, so I did not consider it important.

Of course, it turned out that it had been the outbin calling me to alert me to the fact that some shit was hitting some fans in Shite Town, one of poor Christine’s unfortunate ‘community’-based stomping grounds, as poor reception bloke was forced to eventually admit to me. Not that I displayed it to him, but I was fucking irritated. Not with Christine – I fully recognise and accept that shit hits fans sometimes (especially in Shite Town…God, I hate that bastardhole with a passion) – but with her colleagues back at the bin for letting me drive all the way there when a simple fucking message could have saved me the petrol.

A secondary issue, of course, was that I was right in the midst of a major depression at the time, but meh. I was completely pissed about by (Old)VCB, but NewVCB and Christine have generally been very good in terms of seeing me, and have even afforded me the opportunity to contact them if I am in a non-crisis-team crisis – which, in de facto terms, means any serious (but sub-A&E) crisis, because it will be over my dead body when I ever deal with the bloody crisis team again.

Anyway, so it came to pass that this morning’s appointment was organised, and subsequently attended by both Christine and me. I was with her for about half an hour, which is relatively short by previous standards, but there wasn’t a huge amount of things to discuss. The poor cat had died since I last saw her, which was obviously rather a rather shit stabbing of fate, and it had come at a time when I was very mentally fragile anyway. Christine expressed what appeared to be sincere apologies for our loss, which I appreciated. Some folks say the words alright, but you can almost see them thinking, “but it’s just an animal..!” Others, of whom I’m guessing she must be one, realise that pets become your friends and family.

The odd thing is, apart from the first weekend after Ms Cat’s death, I think things have been stabilising ever so slightly. Obviously, one might reasonably assume that if one had atypical (AKA reactive) depressive symptoms, that such a horrible and untimely occurrence would have paved the way straight back into the depths of the abyss – yet in my case, it did not. It’s not because I’m cold or some sort of unfeeling droid – truly, I miss Ms Cat horribly and am horrified when I think about her being hit by that fucking car, her dying all alone in the middle of the road – but overall, putting a quite normal reaction to bereavement aside (and if viewed from an entirely pathological perspective), things seem to be ever so slightly moving upwards. This makes me feel smug. Why? Because I’ve been trying to tell the quacks for ages now that my moods are not reactive, and that my major depressions are clearly melancholic. What has happened in the wake of Ms Cat’s death exemplifies that well, to my mind.

Lack of a reactive mood suggests a lack of borderline personality disorder. I’ve discussed the fact that I don’t feel the diagnosis is relevant to me any more both here and here, in the latter case having made brief allusion to the issue with Christine herself. Today, I just came out and asked her: what the fuck actually is my current diagnosis?

The question was borne out of a discussion about mood stabilisers. As I had asked you lovely lot here, I so asked her about the pros and cons of Depakote and Lithium, both of which she actually seemed quite positive about. She must have seen some scepticism in my expression, because she asked me to articulate what it was that I didn’t like about them. I presented a redacted version of some of your responses to the aforelinked post.

“I know that’s a tiny amount of people compared to all of those that take these drugs, but still, I’m dubious,” I admitted. “What about Lamotrigine? I heard from various sources that it’s particularly good for depression.”

“Lithium and Depakote are the ones we most frequently use here,” she told me, “but yeah, Lamotrigine and [some other anti-convulsant-cum-mood-stabiliser whose name I have forgotten] are also used, and yes – Lamotrigine does tend to be good for depression. I know that [NewVCB] does recognise the severity of your depressive features. Would you say that they’re the most troublesome part of your illness?”

I thought about it for a moment, and then said they were certainly the most pervasive, which is undoubtedly correct. I kind of screwed up my face, though, because – although depression is a hell beyond the comprehension of those who have never truly experienced it – other symptoms I’ve experienced have been pretty ghastly too. ‘They‘ (especially on a bad day). The particular anti-delight that is the psychiatric mixed state. Insomnia. Fake Paedo and night-time peccaries. Dissociation. They all suck donkey balls that are bigger than I know how to quantify, but despite it all, I think that depression probably is still the worst of the whole sorry lot. It’s inutterably abominable.

For some reason, though, we ended up talking in some detail about my psychotic symptoms; Christine noted that whilst the psychosis had actually been pretty serious at times, that on most occasions it hadn’t been particularly prolonged (save for my ongoing GCHQ obsession, but then I don’t think that that is delusional. Those nosy pricks honourable men and women watch all of us: it’s simply a fact). This is true – in the past I’ve even suggested that my psychotic symptoms were perhaps transient and/or stress-induced, though as I continue walking this darkened path of lunacy and reflect on times gone by, I’m less and less convinced that any of it was (is) as simple as that. Either way, though, it has been uncommon for me to be verbally persecuted or delusional or whatever for long periods of time, as is traditional in the likes of schizophrenia.

One thing I told her, that I haven’t mentioned here for a long time, was that I missed Tom. Not all hallucinatory voices are malicious, y’know. Christine empathised; she says she has one particular patient that has an extremely settled and successful life now (hope, perchance?), but who really misses her voices which (like Tom) were killed by the anti-psychotics that, all things considered, the woman had little choice but to take.

Anyhow, that’s by the by, apart from my worry about reducing the Seroquel to 300mg and adding a mood stabiliser. This concern, as I observed in the appointment, was that even with a slow titration back down to the half-dose of the stuff, I would become psychotic again. Christine reminded me that when I had tried a self-inflicted hand at living on 300mg, that I had only had one day of psychotic mentalness – that the rest of those few weeks, whilst they appeared to have fucked with my mood, had not rekindled voices, paranoia, thought disorder and so forth. True enough, to be fair to her.

“So, maybe 300mg can work to prevent psychosis for you,” she said. “But yeah – I think the introduction of a mood stabiliser is a good idea to make up for the loss of such properties if you lower your dose of Seroquel.”

I nodded, also expressing my willingness to “just deal with the weight gain” if indeed it turned out, after all, that 600mg of the stuff was what I needed. She said that it was good that I had such a philosophical attitude to the whole thing.

“I suppose so,” I adventured, “but I’m going to be taking 300mg of Venlafaxine, 300mg of Seroquel and God knows what dose of a mood stabiliser. That’s a bit…well, mad.”

She shrugged, but not in a dismissive fashion. “If you had a broken leg you you’d put it in as big a cast as it required…”

“Oh don’t get me wrong,” I said, “I agree. I’m not at all one of those anti-medication apologists; the stuff has saved my life many times. It’s just a lot of medicine to be taking when…well, when supposedly dealing with a disorder for which NICE don’t recommend medication…”

Christine made some remark that seemed derisive of NICE, which left me feeling all warm and fuzzy inside. Then she continued by saying that, if I was referring to BPD, then NewVCB was seriously doubtful about my having it.

Good! (Though let’s be clear: I do believe that I did have borderline personality disorder, though I never met the stereotypes so nefariously associated with same – but then, very few people actually do. So here I am – proof that it can be recovered from). But if BPD is no longer applicable, what are we all dealing with, then?

“[NewVCB] doesn’t like to discuss diagnoses with me,” I complained forlornly. “But I’d like to know.”

Christine nodded and said, “I’d say she’s about 90% going with – predominantly depressive, bear in mind – bipolar affective disorder with psychotic features.”

Of course, bipolar type II was always my differential diagnosis, but it now seems that they’re looking at type I. In a way, it’s curious as I’m pretty sure I’ve never intimately danced with a euphoric mania – indeed, (Old)VCB (who met me about four times and was therefore the consummate expert on the idiosyncratic nature of my personal psycho-neurology) stated that I definitely didn’t have bipolar I. However, if I have had mixed episodes – and I certainly have – then clearly, by very definition under the current editions of the ICD and the DSM, it must be bipolar I. I’d always shrugged that reality off: these things exist on a spectrum. I haven’t changed my view on that, but an elevation from II to I is not exactly a non-issue for me, partly because specific diagnoses may (or may not) affect one’s treatment. In that regard – and it’s as unfair as fuck, because the popular, sensationalised images of it are not accurate – not being seen as having BPD any more is a positive development, even though it’ll obviously never leave my files entirely.

Anyhow, there is a window of doubt in this apparent bipolar diagnosis. It is, to no surprise of mine whatsoever, potentially filled with schizoaffective disorder. Essentially, the difference between it and psychotic bipolar disorder is that the psychosis can occur outside mood episodes in schizoaffective disorder, whereas in bipolar (or psychotic depression), such symptoms are exclusive to either depressed or “manic” states (I use the scare quotes* here ((which I normally loathe loathe LOATHE)) because I feel the term denotes euphoria, whereas clearly in my case – if I do have this – then my “mania” is of the dysphoric variety). Given my inability to properly rise from bed in the mornings, it will come as no surprise to you to learn that trying to keep track of my exact state of mood relative to other symptomatology isn’t entirely easy. My sense is that I have hallucinated when fairly euthymic, but then euthymic by my standards could be a mild to moderate depression by those of another, and thus I feel unqualified to judge this objectively.

Oh yeah, and let’s not forget that I still have a number of elements of C-PTSD, regardless of whichever one of the other two conditions is predominant.

I rattle when I walk sometimes, what with all the tablets I have to carry about with me. And that’s going to get even worse! And lo, my poor brain must rattle now, with all these diagnoses in place to form description of it. But, although I know the terms aren’t important and that the actual treatment is, I still see value in diagnoses. I read recently – I can’t remember where, sorry – that the point of diagnostic psychiatry is communication. Without at least some guidance – to be taken with a pinch of salt certainly, but which can act as something of a sign post – surely all branches of medicine, even those in which spectra and classification-overlaps predominate, would end up jargonistic free-for-alls.

Diagnoses may not help diagnosees, but I still can’t see how not having them does either.

* On the point of scare quotes, actually. The verb ‘to label’ and its nominal, adjectival and qualifying derivatives are unlikely to be used synonymously with ‘to diagnose’ on this blog – but if they are, they are the only terms I will always put in scare quotes. I cannot express how much I completely abhor this usage of the word ‘label’. I hate it. I despise it. I feel repugnance and disdain and derision and other derogatory d words towards it (though, it must be noted, not those that use it!).

It’s not a rational objection, but please don’t kick me – we all have foibles, do we not, and this, sweet readers, is one of mine ūüėČ

Random real life aside – in the wake of Ms Cat’s death, we decided to get a new kitty quite quickly. This was a pragmatic decision based on Mr Cat’s future wellbeing. It became quickly apparent that he really missed Ms Cat; so did we, obviously, but human mourning takes time – does the same apply to felids? We know not. Had it been about us, we’d have waited at least a few months before getting another female cat, but on balance, we reckoned it would be better for Mr Cat if a new adoptive sisterbling came sooner rather than later.

So here she is! ShHe shall henceforth be known as Se√Īoritao (Srtao) Gatao on this blog ūüôā [EDIT: As you can perhaps deduce from all the strikethroughs, we thought the bloody cat was a female when we got it, but alas it’s a bloke. We never intended to get another male; the possibility of territorial disputes was too unsavoury. But although Srto Gato annoys Mr Cat with his kitten ways, they actually seem to get on reasonably well. Thank Christ.]

Srta Gata