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.

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).

Any Thoughts on Depakote or Lithium? ***¬°Advice Please!***

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 ūüėÄ 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¬į 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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Futility

Don’t read this if you’re in a bad mood or have an aversion to pointless, inane, self-indulgent whining.

Breathing. Awake – awake almost all the time. Out of bed – somehow. Eating – just. Disillusioned. Hermitting. Ruminating, especially during the wee small hours, swathed as I am in darkness, both literal and figurative, about suicide – spent all last night thinking about the film The [Golden Gate] Bridge, and kept seeing my body flying off it. Too exhausted and fed up to do anything about it, not enough money to buy petrol never mind a flight to California (jumping from GGB causes a horrid death anyhow. There are better ways to go). Avoiding laptop as if it carried Ebola (I haven’t opened it since Thursday or Friday and this is being written on my phone) – I’m positively belligerent towards the poor, innocent thing right now, which is most unusual. Weepy – again, most unlike me. Obsessed with idea that my mother will die – it fills with me with a profoundly horrified dread and deep sorrow that I cannot quantify. Very worried about her on a more rational level due to an arthritis flare-up. Triggered and disturbed by a few things I’ve seen lately. Possibly experiencing tactile hallucinations, but not sure. No other obvious psychotic symptoms. IBS, migraines and knee pain strongly in evidence. Back and neck aren’t good either. Psychosomatic, I suppose. Same nett effect as if issues were organic, though. Intoxicated by the sounds of the wind and the rain – the only positive release and escapism other than reading. Yes, reading! Shockingly I can do this, for which I give my heartfelt and eternal thanks to God(s) in whom I don’t believe. Can’t write, as this spiel of complete shit attests. Lonely but paradoxically desperately desirous of no social interaction at all. Shut down FB – more particularly, not using Twitter or G+, which means things are bad. No idea what’s going on outside my tiny little house and really, honestly, truly don’t care. An aberration for a news and current affairs junkie, surely.

I’ve been at best ambivalent and at worst actively hostile about the future of this blog lately. I go through periods where I loathe it, then others where I remember how truly important to me it is, and how markedly therapeutic it has generally been. I was going to delete the whole thing on Friday night, then again on Saturday, but must have retained some semblance of sanity because I realised (admittedly with some advice from Twitter) that I wasn’t in the correct frame of mind to make a big decision like that.

But I might take a break. Might not. Can’t say. Can’t think straight, don’t care about much, in love with the idea of complete unconsciousness, too fatigued to be angry, useful, or remotely coherent or interesting company.

Odd sense of déjà vu.

Psychiatrist in morning. Logically know this is timely and necessary, realistically dreading the living fuck out of it. Mother’s house afterwards. Unfortunately some McFauls will be there. Cannot avoid them as I need to make sure mother is OK. Hopefully there will be no Paedo though. Christine next week some time. Have so far failed to contact Nexus about renewing therapy as I promised her I would, because I’m avoiding contact with anyone (other that A, in person, and mother, by text message), regardless of reason.

Sorry this is such an unmitigated pile of hot, steaming wankshit. Thought I ought to advise those of you that inexplicably give a damn about me that I do, in fact, still exist. Thanks for comments on recent posts, tweets if you’ve sent them (I haven’t checked, sorry) and whatnot. You do mean a lot to me, I hope you all do know that – I just can’t be part of this world right now.

Much love

Pan ‚̧ xxx

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I Lied – The Mentalism is 'Back'

Didn’t I sound so positive on Friday?

All that positivity about The Book, the proposed voluntary position, blah de blah. Although I seemed like (and am) a work in progress – a person notoriously uncompleted, perhaps – my apparent optimism last week did not seem to represent the words of a person in regression. It didn’t seem to be the commentary of someone whose outward skins of positivity were being painfully sliced off, little by little.

But that’s the truth of the matter.

I didn’t mean to lie. I wasn’t even truly aware at the time that I was lying. I mean, when I wrote “I might be slightly depressed…but given all that has been going on, that’s actually quite good”, I did sort of raise an eye-brow in self-referential suspicion, but I think the crux here is that if I was trying to fool anyone, it was primarily myself.

Things are not continuing to get better, as they had been for some months – and I’ve been very firmly in denial about this. The signs have been very strongly, and at times starkly acutely, in evidence for a couple of weeks now, but until Monday I was in complete denial about them. I ignored them: not consciously, but nevertheless, I believe, deliberately. When they couldn’t be ignored, I attempted to dismiss them as circumstantially appropriate, or nominally sane in some other respect, rather than doing the fucking adult thing and recognising them for what they are – clear, indubitable, glaringly-obvious-with-hindsight signs of an impending serious depression. It isn’t fully that yet, but without action and intervention now, that’s what it will become. I know (and should have known) from bitter experience that that is how this hand plays out.

Why the denial? The short answer is that I don’t really know; in the past, I’ve recognised and accepted going mental when I’ve seen it coming, so it’s hard to determine exactly why I deviated from that pattern this time around. I would hypothesise that, having tasted the pseudo-heady heights of pseudo-recovery, I didn’t want to ‘fail’ myself, to go back on all that I had seemed to have ‘achieved’, by knowing I was slowly becoming ill again. Also, and I know this is hatefully egotistical, but I often feel a sense of responsibility to others, mainly because of the relative success of this blog. I got better – -ish – and wrote about it to the world. It doesn’t look good to suddenly come back one day and say, “sorry, folks, scratch that,” does it?

Also, in this case, the problem is very likely to be attributable to my own stupid decisions. I’ll come back to that later.

I only realised how fucked I was when I spoke to Christine, my CPN, on Monday. I really can’t be bothered going into this in any detail, but essentially I told her I was experiencing the following symptoms:

  • the usual paranoia (still convinced I have schizoaffective disorder, but now also of the view that I have schizoid and/or schizotypal personality disorder, on top of the clinical depression and complex PTSD) – no better nor worse than it was the last time I saw her;
  • agoraphobia – won’t leave the house alone, don’t really want to leave it at all during the day anyway, not always at night, either (though at least then I have A to join me);
  • hideous insomnia;
  • ergo, hideous fatigue – but the levels of it are even greater than I’d expect to correlate with the level of insomnia I’m currently experiencing. I mean, I’m not exactly unused to insomnia;
  • complete and utter apathy and malaise;
  • probably some old other bollocks that I’ve forgotten.

I said to her initially that things hadn’t really changed since our last session together, and I really didn’t think that they had. The above ‘symptoms’ strike me as being part and parcel of everyday existence (to a greater or lesser extent, anyway), and it was not thinking about nor discussing them out loud that made me realise that a major depressive episode is a-callin’. It was Christine’s response to me – to what I detailed, certainly, but mostly towards me specifically.

I seemed different, apparently. I seemed ‘flat’ and disinterested. She said that the absolute confirmation of that assessment came when she asked me about writing; apparently, I spoke of this blog, and even some of my other writing ventures, with complete impassivity and detachment. In the past, she claims, there has always been a ‘spark’ about me when I’ve conversed on these matters, but in this case, I just didn’t care.

I hadn’t realised that I’d previously spoken about the blog with such enthusiasm to Christine, but what I did notice when she asked about it was how much I felt that I just didn’t care. This makes me feel guilty; there are hundreds of thousands (possibly millions?) of words chronicling a huge and important chunk of my life here. There are thousands of (mostly!) supportive and interesting comments. There are dozens of links in the blogroll to the writings of others that I really appreciate. It’s a big deal. I cannot reasonably be apathetic about this, yet I am. That was not the case a few weeks ago.

In talking to her, I also realised how ridiculously irritable I’ve become of late. Don’t worry – I didn’t fly off the handle at her (although when she kept looking at her watch I silently seethed), but she did ask a lot of questions and when I thought about the answers, I realised how narky I have actually been over the last few weeks. I’ve kept that to myself pretty well, but the feeling has certainly been there. I’ve been internally going completely batshit barmy over every single little bloody thing, and though I’ve always been easily irritated to some extent, the sheer intensity and frequency recently experienced is something that is only every present when I’m clinically doolally.

Other things I noticed in the course of the discussion were that I was even more hypervigilant than normal and that I’d behaved really strangely this weekend past. Christine asked me if I was getting out at all, and I said that A and I had gone out on Friday and Saturday night (though of course I advised her that I refuse to go out alone and am still petrified of crowds, and thus spend all day sitting in the house, cowering from the outside world. This concerned her because at points I had been trying to go some places, such as shops, by myself. I haven’t done that for ages). She was pleased that I’d gone out at all, but the weird thing is, on Saturday night when A went to bed, I sat up until 5am watching YouTube videos and smoking.

That might seem like a normal thing to anyone else in the world, but it’s odd behaviour for me. There are occasions when I stay up later than A, but they’re usually to write because in a cruel twist of fate, most of my ‘inspiration’ seems to come around the witching hour. This was different – I don’t know why it’s so odd that I would remain up whilst he went to bed, I don’t know why it’s so odd to listen to music videos whilst alone…but it is. It’s just not me at all.

She asked me if I had even enjoyed my late night pursuit. I laughed, and said that I’d taken no pleasure from it at all, but that I couldn’t seem to tear myself away from it. I said I was taking pleasure from almost nothing (save for writing the first chapter of The Book, not that I told her about that), all over again. A different tact, then; what about motivation for anything? Don’t be daft, Christine love, it simply doesn’t exist. Have I any social contact? Meh, occasionally I check Twitter. No, no, she meant in real life. Of course – A is there. But A is only there in the evenings, is he not? Well…yeah. What about my mother? Yes, my mother is there, I can go up to her house again now that AoE and The Everythinger are gone. Good, right?

But…I don’t want to talk. I don’t want to use my vocal chords at all: it is so much effort. Whilst I can get away with this in A’s company, it’s not possible in Mum’s; A can entertain himself quite easily with computer games or whatever, whereas my mother, at least when I’m with her, seems to need verbal social interaction in order to even breathe. Yet I’m too tired to speak. Speaking a few words seems akin to remastering the theory of relativity right now, so I dread the idea of having an entire conversation.

So, Christine mused, if I don’t want to (or literally can’t, at times) talk to anyone, am I willing to even see anyone? Well, Mum and A, yes – despite the communication problems inherent in seeing anybody. But beyond that, no. I’d rather gouge out my eyeballs with a rusty fork and stick them so far up my anus they come out in next year’s vomit than see anyone right now. I did force myself to have lunch with my oldest friend Brian about a fortnight ago, because I’d essentially ignored his text messages and Facebastard comments and so forth for ages, and knew I was being a shit friend. However, if I could have gotten out of it with any ounce of integrity left intact, I would have done so in a heartbeat. The meeting was awful; Brian is a lovely bloke, and we’ve known each other for so long that there will always be something to say, but I couldn’t feel anything other than selfish frustration that I had to be out of the house (fortunately, as ever, I think I hid it well).

And that brings me to another point. I felt hideously guilty for not enjoying lunch with Brian; I feel hideously guilty for not wanting to speak, especially to Mum because she’s so nice and she’s so lonely oftentimes; I felt guilty for complaining to Christine about not wanting to speak, because in doing so I was speaking, so she probably thought I was angry with her for ‘making’ me engage in that; I felt guilty for being irritable; I felt guilty for not being more respectful and appreciative of this blog; I then felt guilty for being narcissistic enough to think that people actually care about it; I felt guilty for thinking that almost everyone is out to get me; I felt guilty for my general issues of anhedonia and avolition, because when you think about it, life hasn’t really been too cruel to me, and I should be bloody grateful for what I have.

Christine cocked her head, and lifted her eyes to me. “Excessive guilt,” she said simply. An explanation of the term was not necessary. I am well aware that it is a symptom of a major depressive episode. Not that I felt or feel that the guilt is excessive, but she apparently did.

“OK,” she finally continued. “Your mood, your general demeanour, has definitely changed since I saw you last.” As noted, I’m not sure how, but then I can only observe myself from within. “You’re just…” …she searched for the correct terminology… “…not yourself, not the person I’m used to meeting.”

I thought about this for a moment. How can she know what ‘myself’ truly is? I see her for an hour every fortnight or three weeks, for Christ’s sake! But I forced myself to try to see things from her perspective, and realised that if my demeanour had indeed changed, then in fact surely it is her of all people that would notice. A sees me every day, Mum once a week. Any changes to them would be subtle, and only clearly observable retrospectively. An analogy would be when we got our cats as kittens. We didn’t notice them aging day to day, but when my sister-in-law – who was with us the day we took them home – saw them several months later, she very clearly noticed how much they’d grown. I suppose observable shifts in mood are a bit like that.

Indeed, I remember when I got my accursed medical notes (yes, those things that I didn’t bother doing anything useful with – fail fail fail fail fail), the letters from Psychiatry to Lovely GP would detail my mood self-reports and then their ‘objective’ assessments. Now don’t get me wrong, I certainly don’t always (or even often) agree with their alleged ‘objectivity’; however, unlike many within this discipline, Christine is a no-bullshitter, and the more we talked about how things were, the more I grew to see that she was right. Things are Heading South.

So, then. What caused it?

I tried to blame it on insomnia. If I can’t sleep, then it’s inevitable that my mood is going to drop. She accepted that, to a point, but asked if I was still feeling so apathetic and (sometimes willfully) disconnected from the world when I had taken Zopiclone and ergo had had at least some sleep. I was forced to admit that I was. In all honesty, sleeping hadn’t really affected that at all.

“Ah well,” I sighed. “These things do go in circles, don’t they? I’ve never been stupid enough to believe that I wouldn’t go through another major depression. It’s always going to be a part of my life in some fashion.”

“Hmm,” she replied, uncertainly. “Maybe. But I’m just wondering…how long has it been since you sliced your Seroquel dosage in half?”

“About five weeks…” I began.

“And how long has this…this downward slide been going on? About three?”

“Um…yes, I suppose so. But it can’t be anything to do with the Seroquel, can it? I mean, I know it’s used as an anti-depressant, but I thought that was at lower doses. [NewVCB] told me that the maintenance dosage of it for depressive features is 300mg.”

“As a general rule, it is,” Christine replied. “But it doesn’t mean that the mood stabilising and anti-depressant properties aren’t applicable in higher doses – and anyhow, you seem to have a high tolerance to medication to begin with. Everyone responds differently to different doses of medication, as you know.”

I had to concede those points to her, and after debating it in my head for a couple of minutes, I was forced to recognise that the timing of my apparent descent back into madness relative to my idiotic decision to reduce my daily intake of Seroquel was highly coincidental.

“And I don’t believe in coincidences,” I added softly.

She nodded. “Neither do I. I don’t know if you know this, but in the XR version of Seroquel [the one I take], the anti-depressant properties are more potent than in the standard version [no, I didn’t know this. I thought extended release was just that – so why does that have an impact on mood more so than getting the hit all at once?], so I think that further evidences the fact that there’s a connection here.”

“But,” I protested, “I have had no hallucinations at all since I reduced the dose, and that day of heightened paranoia last month was when I was still taking 600mg.”

“Even so,” she shrugged. “The depressive and anhedonic symptoms still strike me as being related.”

Maybe the psychosis remits. Maybe it only occurs in times of stress (so maybe I don’t have schizoaffective disorder, as I posited at the beginning of this post. Though I still think I do). Maybe it simply can’t be bothered right now, and will return down the line a bit along with some other nefarious attacks on my psyche, such as the hateful mental prison that is the psychiatric mixed state. Maybe it only comes at all when I’m in the midst of a full-blown mood episode (therefore, again, possibly ruling out schizoaffective disorder, and suggesting psychotic depression or bipolar disorder). I mean, when you’re terrified by hallucinations, it isn’t your first priority to start assessing what your general mood state has been at the time, so I really don’t know.

Who cares. Whatever the case, psychosis or no psychosis, I was forced to agree that it looked very likely that the reduction in Seroquel had dramatically affected my psychological well-being.

“If I were you, I’d very seriously consider going back on to the 600mg,” Christine told me.

“What, tonight?” I checked.

“Yes. And if you find that you still want to reduce it after that, discuss it with [NewVCB] in your appointment on 7th September, and she can maybe consider tapering it down or something. But for now, I really think you should go back on it until you see her. I know it’s only a fortnight, but…”

“…that’s a long time when you’re going mental,” I finished despondently, and she nodded her agreement.

“What do you think about that?” she asked.

“I reduced the Seroquel because I was sick of not being able to get up in the mornings. and then experiencing this repulsive, zombified hangover when I did. But I’d rather both of those than be mental – particularly ‘mental’ in the form of ‘depressed’. I’m just worried about the weight gain. It makes me need chocolate, which is contrary to my nature. I’ve never really had a sweet tooth, but as soon as I started taking 600mg of this stuff, I developed one that is surely unparalleled across space and time.”

“We can discuss that, if it continues,” she said. “If you can get back your interest in things, then maybe you can start taking occasional trips to the swimming pool, for example, and build it up from there. If your mood is better to begin with, things like that will seem less daunting.”

I inhaled deeply. “OK. I’ll increase it again. If this is the start of a black treacle of depression, I want to nip it in the bud before it gets out of hand. If I can. Maybe it’s already too late?”

“Possibly, but by no means definitely,” Christine replied. “You may well be able to stop this before it becomes significantly worse. And at least you have a psychiatric appointment soon, and that will help guide us from there.”

I have been back on the 600mg of Seroquel for two nights now. Obviously two nights isn’t going to make a difference, but let’s just see where we are with the depression thing. I don’t feel depressed as such – Christine, when I said that to her, once again used the adjective ‘flat’ to describe my disposition – but the curious thing about depressive episodes is that they’re not always characterised by raw despair itself; many other things can mould themselves into that horrible, amorphous shape. So, as I did in February, I’m going to use those amazingly accurate, wonderfully telling and obviously entirely diagnostically valid depression scales to see what the craic is.

Goldberg – 68
Beck – 53
Hamilton – 37
Burns – 89

Look at the fucking score on the Beck Inventory! All the others are slightly better than February, but it is a fuckload worse. By fucking miles! Either I inaccurately recorded my Beck scores when I previously did this test, or things have really fucked up, because I think I’ve been honest in my answers today. Perhaps the thing with it is that it places a lot more emphasis on behaviour and thoughts, rather than depressed feelings alone, than some of the other assessments do. But whatever the case, that isn’t good.

Perhaps one of the biggest indicators that things are not good is the fact that I collapsed on Monday night. I just blanked out – presumably I fainted – and fell, with the next thing I knew being my lying on the floor. Mum, who is trying to buy a new car, kept asking me to stand behind her at the computer as she looked up endless reams of automotive specifications, and I was so fucking exhausted that even that was an effort akin to climbing Mount Kiliman-fucking-jaro. So I apparently responded somatically, and passed out. Don’t worry; I wasn’t hurt or anything. But I do think that all factors, when detailed here together, suggest that until things start to demonstrably improve, I have to be very, very careful.

My concentration isn’t as bad as it normally is when I’m off my head, so maybe I can seek some solace in writing The Book. Yet even that seems like it has to be treated with kid-gloves, because writing can very quickly wear even the sanest person out (I’ve been writing this fucking post on and off since Monday afternoon!). Take it easy, The Eagles once sang. Good advice, that.

Those of you that read TWIM will know that on Saturday I featured, as one of the wildcards, a blog denouncing the inappropriate use of quotation marks. You might very well attempt to protest at my use of said marks in the title of this blog post, but you can’t put me on trial for hypocritical punctuation abuse just yet (at least, not for that. I’m sure there’s a multitude of errors within this post, but I’m typing on my mother’s netbook which makes things difficult and, furthermore, I’m a bit mental and can’t be arsed to proof-read this. So suck it). I put the word ‘back’ in quotes because it isn’t back; it can’t be, because it was never away. It was, and is, always there – just to greater or lesser extents that can or can’t be easily managed. ‘Back’ seemed like the most appropriate word given the apparent change in intensity, however, so there you go.

I’m really, really not a fan of BBC3 in the least, but BBC1 happened to repeat this programme originally broadcast on the former last night. It’s a surprisingly sensitive and interesting look at how caring for a parent with mental illness can affect a young person. If your country allows you access to the BBC iPlayer, do check it out ūüôā

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Apropos of Nothing

Writing is a lonely profession (if indeed it can ever be turned into a ‘profession’). But that loneliness is somehow comforting in its own paced-ness, in its ability to protect one from the perils of the outside (some would say ‘real’) world. The pursuit, whilst thoroughly without guarantees and assurances, is still a safe one – published or not, you still have the pleasure of composition, and of knowing, eventually, that you have completed something that at least has potential, if to no one else but to you.

What this amounts to is this. I’m writing a book. I’m not wont to discuss it in detail on a public forum like this blog, but it is going to be mental health related. Many of you have inexplicably but kindly asked me if I would turn this very blog into a book, but that isn’t my plan at this stage, for two key reasons. One is the simple fact that the intended book’s concept is already very clear in my mind, and I don’t want to deviate from that while it’s so vivid. The second is that going through everything written here – post by post, word by almost-endless word – is one hell of a task to take on, especially when my mental health is still relatively fragile. I’d like to maybe do it some day, but not now. Sorry ūüė¶

Also, you see, in doing all the factual writing of late that I have – here, and in other arenas – I realised that I hadn’t done any creative¬†writing since…fuck, I don’t know. Since I was at school? Maybe even since my GCSEs? That’s a horrible realisation, to know that I’ve neglected a passion of mine for such a disgustingly long period. I used to love writing fiction, and I’ve only recently realised that I miss it.

So, The Book will be a fictional narrative. Whether it’ll turn out to be a novel, a novella or a short (as if!) story, I don’t yet know, but I don’t really mind whatever the case may be. I also don’t really care if anyone is willing to publish it or not; I mean, it would be lovely if someone did, that much is self-evident – but I’m doing primarily for my own pleasure. I had genuinely forgotten what escapism and what joy comes from such a simple pass time, and I’m revelling in it at the minute.

So I haven’t written much here this week, since the idea for The Book came to me. It isn’t just¬†The Book that is keeping me away, though the other factors are still within the literary realm – I’ve been reading voraciously, planning a few pieces of non-fictional writing, and even the odd non-writing bit of so-called creativity too.

I just thought I should post something, drivelsome and dull as this is, to show you that I’m still alive, and that I’m doing relatively well. Since I cut back on the Seroquel, I haven’t been sleeping well (unsurprisingly) and have had to resort to take Zopiclone on many nights. The new neighbours and their screamer are not assisting in my quest for slumber (they keep the strangest hours, especially for a family, that I’ve ever encountered. They arrive home, child in tow, about 11.30pm, then proceed to talk half the night on the phone, child still in tow. What the fuck?). However, beyond that, I’m OK. Things aren’t amazing, and I might be slightly depressed – but I’m managing, and given everything that’s happened over the last three years, at the moment I really think that that’s good enough.

And it is¬†three years. It’s just over three years now since I left my own little office for the last time. I noted above that writing is lonely, and it is. But having your own office,¬†glamorous¬†as it may sound, is¬†lonely¬†too, yet it doesn’t have any of the advantages that working from a laptop on your own sofa does. Nonetheless, I miss it in some ways: at least the people who worked in the offices bordering mine were, generally, good people, and were I feeling a bit lost, I could normally wander in next door and have a quick chat with them, before returning to my own quiet domain. I can’t do that when I’m sitting here typing all day.

To that end, as well as writing The Book, I’m applying for a voluntary job. I think I might have mentioned this before, but I’m finally going to do it, and whilst I’m extremely nervous, I’m also quite excited about its potential as well. I haven’t put in the application yet, but I plan to this week…and then we’ll see. At present, I’m only going to offer the organisation a few hours a week, but for the type of position I’m hoping to get, I suspect that for the moment that’s more than adequate. If not, and if it works out, and if I even get it¬†for that matter, I might be willing to increase the hours a little bit further down the line.

I don’t know why any of you like this blog, but since some apparently do (thank you!), please be assured that none of this means I’m winding it down or anything. I’m trying to plan the final posts on Paul, and a few other bits and pieces, so you can’t get rid of me that easily ūüôā I just won’t promise that I’ll post once a week or more, as I usually try to do. We’ll see how it goes. But Confessions¬†will remain, so worry not ūüôā This is very far from ‘goodbye’; it’s simply a boring “here’s where I’m at right now” update.

What else? The Everythinger is gone (YAY!), I’m seeing Christine on Monday, NewVCB at the start of September, and I’m probably going to re-contact Nexus some time next month to re-embark on therapy. Part of me dreads that for what I assume are obvious reasons, but mostly I feel reassured and hopeful about the potential of it, given how useful my last course with Paul was. I’m back into something of a routine now that both Aunt of Evil and The Everythinger are gone, A seems a little less stressed at work than he had been, and I’m relieved that both Daniel and CVM are both alive and well and that the stupid riots in England appear to be over.

And that’s about it really. That’s what’s been happening in Pan’s world of late. I hope your existence has been more interesting but at least equally stable, and that you’re all well and happy ūüôā

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