The Inevitable 'Goodbye' Post

Not Dead, Just Sleeping…

Happy birthday to me
Happy birthday to me
Happy birthday, dear Confessions
Happy birthday to me!

Confessions of a Serial Insomniac began exactly three years ago today with the first incarnation of the ubiquitous About page. It seems fitting and right that it meets its pseudo-demise on its birthday. It’s a nice, round timeframe.

Those of you that are regular readers will have seen this coming for months. Indeed, I’ve discussed it with several of you over the last…I don’t know, eight or ten weeks, maybe more. My passion for this place – once overwhelming – has waned profoundly, and it would feel a disservice to the blog to simply abandon it, rather than tying up its loose ends.

There’s so much I want to say that I hardly know where to start. I’ll jump in, then, with practicalities.

  • I said in a recent post that I intended to discuss my new set of sessions with Paul on the blog. I’m not going to do that after all, for which my apologies are due. I’ll outline the primary reason for this later.
  • I never did finish my series on my aunt Maisie’s demise. Again, apologies for those of you that were mad enough to be interested. To be honest, although I could have made the further details of the funeral into an epic yet dull piece of prose, not much of note really happened. Her coffin was carried up the road a bit, the eight men underneath it bulking under its weight. I once again, inexplicably, envied my cousins’ comforting of each other. Maisie was buried, atop a hill, in the sunlight. I cried again, like the sad cunt I apparently am. We went to the tedious, oppressive wake (on which, ironically, Maisie would have completely thrived). The only real out-of-the-ordinary incident was to do with Aunt of Evil. After hours of successfully avoiding the accursed woman, she managed to catch me out whilst I was aimlessly talking to her brother-in-law, Uncle of Boredom. Long story short: although she apologised to me for “whatever it was [she] ha[d] done” (as if she didn’t fucking know!), I ended up apologising to her too! I raged with myself for weeks, because I had done nothing to the heinous witch to warrant any words of atonement, but then I remembered she’d gone back to USistan without my having seen or spoken to her again, and I settled a bit.
  • Twitter and Facebook. I’ll keep them both ‘officially’ open, I think – Twitter especially holds so much history for me – but I’m very unlikely to be updating or checking either. Don’t unfollow them, though (unless you’re sick of me, which is obviously reasonable enough); you never know where and when I may re-crop up…
  • Although I’m finishing my writing tenure here, I’m not taking the blog down; it’ll still be fully accessible. Many of the search terms over the years – and the regular readers I’ve picked up therefrom – have suggested to me that some people have actually found parts of this rubbish useful, or at least enjoyable (!). I don’t want to deny others the opportunity to explore it should they so wish, and in any case the domain name and hosting are paid up until at least January 2013, so they might as well be made use of.
  • You can still contact me, though I’ll be disabling the contact form soon and, as observed, will probably not be hanging about Twitter. Instead, email me at pandora dot urquharthuxley at gmail dot com. This arrangement will most likely not be permanent either, but it will bridge a gap at least.

Now then. I suppose I should try to outline my reasons for leaving this place, my much-loved home for three years – the place where I met so many amazing people, garnered so much support and spouted so much crap that offered a surprising amount of catharsis. As I sit here and write this, it almost feels like folly to quit; Confessions has brought me so much, and here I am rejecting it. I will mourn it, and do so profoundly; it has shaped my life beyond my wildest dreams during its course, so how could I not?

But I am not this person any more.

I think there comes a time in the lives of most mental people where they realise, or accept, that they are defined by something greater than their diagnoses. For the most part, I have seen my life since 2008 – and, to a lesser extent, since I was a teenager – as an experience which was shaped by my diseased mind and its treacherous idiosyncrasies. Of late, though, I’ve begun to think differently of myself. I’m not naive, and I’m not an idealist: I have a mental illness, and although that can potentially be managed, I will almost certainly always have it. My views have not changed so radically that I now see myself as someone who has ‘pathologised her humanity‘ or some such other patronising fucking nonsense. Nonetheless, ‘mental’ is no longer the first word jumping from my lips when someone asks me about myself.

I suppose I could adapt Confessions to reflect this – I could write about gaming, books, pubs I like, holidays I’ve been on. But it does not, in any fashion, feel right; this has always been a blog about mental health, and I feel it more apt to let it stay that way. So as I as a person move on, so must my blog.

There are wider issues than just this, of course. Logistically speaking, I don’t always have time to write here any more, at least not in the essay-ish style to which I’ve always been prone. Again, I feel it would be a disservice to the legacy of what I’ve done with this journal to modify my writing style to facilitate shorter posts; it’s just not what this all became over the course of its life. I’ve had it said to me by a few people that my longest posts – probably because they’re the ones in which I’ve become most immersed – are my best, and I’d rather be remembered for that than for something that just dribbled dry over time. At the risk of employing a vulgar cliche, as Neil Young (and, more famously, Kurt Cobain) put it, it’s better to burn out than to fade away.

Additionally, to quote one of my favourite writers who has also lately bowed out of anonymous blogging, I am tired of pretending. I’ve long-since hated the anonymity that this place affords me – not because I hate the persona that you all know as Pandora, for she has become an irrevocable part of ‘me’, and despite it all, I actually don’t hate myself (and am not sure that I ever truly did). It’s because I am not ashamed of who I am, of who I have become, of what I have, and of what I don’t. The matters discussed on this journal have actively required that I cloak myself behind a pseudonym, but, again, I no longer see myself as someone solely prescribed and designated as a victim of sexual abuse or vicious hallucinations. To that end, I presently don’t need my anonymity (at least for pursuits unconnected to this website).

The final straw was in therapy recently. Nominally, Paul and I were having a proper therapeutic conversation, though he did at the end comment that it had been a strange session. It was, because I was not properly in it. Thankfully – or not – that had nothing to do with fucking Aurora; it was me playing games with myself. To get to the bloody point, I was sitting there considering in detailed terms how I could frame our discussion in dialogue-driven, prosaic terms – did he raise an eyebrow here, did I sneer at something there? – for this blog.

That is not healthy. I knew right then that I had to stop writing here. Therapy is meant to be a life-enriching, remedial experience; it’s not fucking blogging fodder. In the sessions that followed, having made up my mind to close things down, we were able to do much more fulfilling work together.

Naturally, this has a downside; I am unable to express to A, for example, the kind of material covered in session. I regret that, but I feel that healthy psychotherapy is more important for all concerned than others having insight into the process as it happens to me. If that sounds blunt, please forgive me: my point is that if I am unwell (as, without adequate, concentrated treatment, I will be), then everyone around me is affected. That’s no more fair on them – and probably you, as a reader – than it is on me.

I am a horrendously jealous person – I freely admit it. When I log on to that bloody curse that is Facebook – I really should deactivate it yet again – I see people I went to school with having brats and developing the careers they always wanted. I’m not envious of the former per se because, as you know, I’m childfree. But I am jealous of them having what they want, and of their apparent happiness with their lives.

But, you know, when I think about it all in context, when I think of all I’ve faced and all I’ve done – or at least tried to do – it doesn’t seem quite so bad.

I didn’t have the best start in life, whether through social factors, chemical ones or ones relating to my own psychology (or, in my view, a combination of all thereof). I could have let my resulting mental illness fuck me entirely – and at times it nearly has, and indeed it still might – but I fight with every weapon my arsenal allows me; I actively try to help myself get better. I engage with all services available to me – psychiatry, nursing and therapy (indeed, I had to go out of my way to secure the latter, after NHS Psychology shat on my face, rather than lying down under it like I could have done). I co-operate with them all despite the fact that they – like almost anything – are not perfect, because I don’t want this non-life any more. I want that sense of contentment that those twats on Facebook appear to have.

Although I’m still ill, I refuse to tolerate the idea that I should stay on state benefits indefinitely. That is most indubitably not to say that mentals (or anyone else with a serious and/or enduring illness) should be forced off ESA and other benefits. Fuck the Coalition and their myopic, dangerous biases; our first concern as a society should be to support individuals who are disabled, ill and/or vulnerable, rather than lowering taxes for people who can afford to fucking pay for them.

Still, I ultimately want to be self-sufficient, despite the perhaps precarious position in which I find myself. It may not happen any time soon, but I want to, when possible, try.

I’m pragmatic enough to realise that my illness can’t be cured, merely managed, and as such although in an ideal world I’d go back to a more traditional job, I realise that it may (and only ‘may’) not be possible (or at least sustainable).

So, for now at least, I write. I consider myself a writer now, regardless of whether others think the title narcissistic or grandiose. This is partly why I don’t have as much time as I once did for Confessions; it’s sad, but it’s real. As my best mate Dan (himself a full-time staff journalist) discussed the other day, I’ve made genuine in-roads into turning what was once a vague fairytale idea into a reality. I’m talking to Editors, engaging with the low-paying but still useful services of and eLance, getting my (real) name out there…and I’ve applied for a voluntary job which will involve, if I get it, writing for the local rags about mental illness. Most of my writing to date has been in relatively specialist publications and websites, so writing for the papers – a more mainstream pursuit, with wider readerships – would be a welcome challenge, and indeed a useful addition to my portfolio.

Oh, and The Book? It’s back on ūüôā I’m also half-minded to try and novelise this blog at some point, but that would be an immense piece of work – even harder than a random piece of fiction, because it would require endless re-working of Confessions, rather than putting a bunch of ideas down on paper and formulating them into prose. If The Book ultimately has any success, I may be buoyed to work on such a monolithic task, but we’ll just have to wait and see.

My writing ‘career’ may fail…but, again, I’m trying to make something of my life. It’s very difficult right now, what with not being fully well, and there are days when it’s impossible to face. There are days when anything is impossible to face. But I’m starting, and that’s got to count for something. If it goes tits up – yes, that’ll be disappointing. That much goes without saying. But I’d rather have that potential outcome than that in which I didn’t give it a damn good go.

And I feel a little better each day. A bit less depressed, a bit less despairing, a bit more positive, a bit more hopeful. My current medication cocktail, combined with an ever-excellent psychotherapist, has brought me closer to wellness than I’ve been in a very long time, despite the truly abysmal year this has been, circumstantially, so far. As I said way up above, I no longer see myself entirely through the lens of a mentally ill kaleidoscope.

In the years since my most recent breakdown, I’ve often cursed my psychic misfortune (aside from the fact that no, I still probably wouldn’t flick the sanity switch were I offered the option). Further, I’ve cursed this blog (sometimes for valid reasons, sometimes just in rage-fuelled piques). And yet…look what both my madness and my blogging have brought me.

  • A half-credible chance to use my afflictions to facilitate a respectable career, whilst simultaneously advocating for others in the same shitty boat.
  • Most importantly, I have met some of the most wonderful people in the entire known universe – people who (God/Buddha/Allah/Flying Spaghetti Monster/Richard Dawkins willing) will be lifelong friends.

Throw in the gratifying fact that I’m in a long-term – and, more crucially, happy – relationship with a loving, accepting partner. Multiply that by the other genuinely meaningful and life-changing friendships I have managed to forge throughout my life – Dan, Brian, Aaron, lots of people that are not close friends but that are certainly more than acquaintances. Minus the disastrously dysfunctional family, but add to the list a loving mother – something that not everyone is fortunate enough to have.

When I think about things thus, when I examine my life as though it were the Bayeux Tapestry, looking at the ‘bigger picture’ (I hate that fucking term) – well, I feel privileged.

And at the risk of repeating myself, in these circumstances, I find myself sometimes thinking, “do you know what, Pan? You ultimately did well, girl. You did well.”

And, for now at least, that’s enough.

Is this completely ‘goodbye’? Not necessarily. A number of you already follow another blog I write, and I will consider requests for the URL from others (email me as per the details at the start of the post, though please do not be offended if I don’t respond with the address; I don’t write exclusively about mentalness there, and don’t want it to become what this blog has). Furthermore, I may add the odd update here once in a very occasional while. And let’s not forget that when Maisie died, despite my pre-existing intention to wind down Confessions, I immediately gravitated here and ended up writing quite a lot; as it had been so many times before, the blog was my haven and lustration. Right at the top of this entry, I used the words ‘not dead, just sleeping’. So, when things inevitably go downhill again, or when some other life event once again sends me down the figurative shitter, this place could be resurrected. So do keep me on your RSS Readers and social media profiles just in case ūüôā I’m not offering any guarantees, and I’m certainly not saying it’s even likely. It would be folly to rule anything in, or rule anything out, though, so there you have it.

Whatever happens, thank you for sharing this madness with me. Your support, tolerance, friendship, and even love has made my life better – and literally saved me on occasion. I’m pretty convinced I’d either be dead or much more seriously ill than I presently am had it not been for the amazing people I’ve met through writing here.

In the parting words of the Ninth Doctor: you were fantastic – absolutely fantastic. And do you know what? So was I!

Farewell, my loves. Cue trite, manufactured, but tackily appropriate song from (who else but?! ;)) Lunatica.

…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.”


“And if I don’t go with you..?”

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


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.

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…


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.


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

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.


The Evolution of Goldfish – Paul: Week 22

Right. For absolute God’s sake, Pandora, just write this fucking post and stop finding procrastination-borne ways of avoiding it.

It’s not that there’s anything particularly traumatic about what I’m intending to write, but these session reviews are long and tiring in their composition, and moreover, because it’s from a couple of months ago, the feeling is not as ripe in my mind as I’d prefer it to be. That’s entirely my own fault, of course; I have had plenty of opportunity to finish writing about Paul well before now. Instead, I’ve chosen to dick about – oh look, *shiny thing*! Fuck’s sake. Anyhow, the notes do remind me of some of the nuances and subtleties of the sessions – the way he might peer over his glasses, the palpable expression of hurt or rage within the room, my constant hair-playing – but I’m not sure if I’ll ever nail them quite to the standard I would have had I written them up in the afternoons immediately following the appointments. But therapy is a draining pursuit, and so it’s hard to summon the internal mental energy necessary to engage in such writing; to that end, I’m not going to promise to hold to that ideal when I return to Nexus in the next couple of months. I’ll try, but for at least some of the time, I will fail.

Anyway, here we go…

Paul was met with my usual opening gambit of complete, hair-fiddling silence, though it was eventually me that broke it by castigating the living shit out of myself for my failure to speak. He responded with some remark about my feeling that I ‘have to’ speak, and about how that made me ‘trapped’. He went on in an entirely predictable fashion: I still frequently behave as if I’m helpless and have to do as I am told. I am reminded of how submissive I really am in ‘real life’. Everything – well, most things – are given deferential consideration before I dare to respond, and generally I will kowtow to the other party’s wishes in the end anyway, even if I loathe them for it. My last-but-one job, of which I’ve never really had reason to speak here, is a glaring example that still (four and a half years later) sends shudders through my body.

After a great deal of fairly repetitive discussion surrounding Hotel California and my aforementioned submissiveness, he eventually went on to say that my current methods of coping with things and defending myself were such that I was ‘trapped’ in this world, and that Aurora was ‘trapped’ in her world, which is full of pain. “To you,” he continued, “she’s just a nagging problem. She buggered up your life, so although you’re intellectually aware of all the facts – that she was abused and badly hurt – you can’t really empathise with her, can you?”

It depends when you ask me, actually, which in and of itself is progress to my mind. I said that I had written an awful lot on this blog (I can’t be bothered to look for the link((s)) right now, sorry) about how my position shifted about, on how I recognised that I didn’t deserve any of it at all, and, crucially, about how I really felt all of that, rather than just knowing it as an abstract sort of concept.

“But,” I said, inevitably, “then I think of my fat five-year-old face and I feel nothing but disgust. If you put my mere outline in place of that image, I can pity and empathise with and wish to protect her, but not if it’s actually the young me. And then, of course, that leads to tremendous guilt because regardless of what I was like, I should still feel that concern for my younger self.”

Paul asked me to put Paedo into this mental vision that I’d conjured up and which was fucking with my head. In that time-honoured fashion of therapists everywhere, he asked me, “how does that feel?” (At least the emphasis here was on something specific, rather than on some amorphous abstract as it so often was with C).

I closed my eyes and let the image consume me for a minute. It wasn’t at all pleasant, but I tried to walk him through it.

“I feel fear, I suppose. Not intense terror in that Lovecraftian horror sort of way [Jesus, how up my own hole am I?], but…well. It’s more like I’d respond to a hallucination. Trepidation, perhaps?” Self-created Paedo leered at me in my mind. Aurora took a step back. I – the envisioned adult me – looked at him with an examining and curious sort of contempt, but none of the three assembled psychic (non-)personnel spoke.

Paul went at me again for trying to over-analyse the scenario, though he did admit to my description being a realistic one (in the sense that, the first time or two, rapes that are the start of systematic abuse are met with overwhelming terror – but that gives way a resigned stoicism as the abuse continues). “What else?” he pressed. “What is she feeling?”

I ‘looked’ at her. She didn’t look petrified at all, but I felt a sense of dread emanating from her. I suddenly knew what she was feeling, even if there’s not a specific name for it.

“It’s a sense of ‘oh no, not again’,” I told him.

“Not the reaction of a blameful child,” he mused. “More like a helpless wee girl.”

(Completely off-topic, but does anyone else find it odd – not bad, just a bit weird-sounding – when someone who isn’t Scottish or Irish says the word ‘wee’? I remember reflecting on this that day: how interesting it was to hear a Brummie say ‘wee’ ((utterly disregarding the fact that Paul has lived here for years, of course)), yet I say it a hundred times a day. Funny the little things you pointlessly ruminate upon whilst in therapy).

“I agree with you,” I admitted, “it’s just…” …I started my usual carry-on of being unable to articulate the words I wanted to convey… “it’s just that I can’t…can’t throw off this…this persistent self-disgust. That picture of me when I was five that I mentioned…Jesus, it makes me cringe.” Pause. “But…being cringe-worthy does not equate to being at fault for being used as a sex toy.”

“Indeed,” he nodded, his head cocked, his eyes unblinkingly fixated upon me. I wondered what it was that he was so intently looking for. A manifestation of how I was feeling? A tell, as we call it in poker circles?

“Indeed,” he repeated. “You could have been the worst child on Earth and you still woundn’t have deserved a second of it.”

“Do you remember I told you about the picture of the baby?” I asked.

“Yes. That was hugely significant, I thought. You looked at that little baby and thought, ‘You’re just an innocent baby – yet you’ll have that taken away from you before long. I know your future’.”

“I still think there’s something terribly sad about that,” I confessed, fixating my own gaze upon Random Point A on the off-green, non-descript carpet. I could feel his eyes upon me, but I refused to look at him. A lot of stuff was circling in my whirlwind of a mind, and it was frankly quite horrible to think about the issues this conversation raised. I don’t know why. I don’t like babies any more or less than I like five year olds, so my reaction to this one seemed wholly out of character.

“There is something sad about it,” Paul replied, “tremendously so. I recall the sadness in the room when we talked about that before. In fact, when I was writing up my notes on that session, ‘sad’ is the word I used. I think…I think you have some sort of separation from the baby. You can’t remember yourself then, you can’t see any of the physical characteristics you now have [wanna bet, Paul? The baby is certainly fat, so we have that in common], so perhaps you don’t think of it being really yourself.”

He’s right. I don’t.

But the picture of the baby was only once facet of therapeutic discussion that I thought particularly relevant: the other was the session in which we pretty much ignored the sexual abuse and focused on my parents and their tumultuous relationship. In the aftermath of that, and in particular in my writing it up here, I was a complete heap of psychological spaghetti, and at one point, seeing me in a flood of proper tears, A opined that “the therapy [was] finally starting to work.”

“I am given to believe that crying is a more appropriate way of expressing distress than other ways I have I might have chosen,” I self-decried.

Paul cocked his head. “You still view crying with contempt, then.”

Um…yeah. Of course I do. As I said to him, people look strange when they’re crying, and I don’t want to look any stranger than I already do.

I laughed then. “That coming from the girl who dyes her hair pink, blue, green, purple, etc.”

“What’s that about?” he queried. “The hair dying.”

Fucking psychology. Why does something always have to reflect something apparently deeper?! I drolly and cynically responded that presumably I was ‘seeking an identity’, and waited for him to lap the comment up in scrutiny.

Instead, for once he surprised me in dismissing the potential psychoanalytic ramifications of this most ordinary thing. He said, “maybe you just like dying your hair. My former mentor once told me that you don’t have to analyse everything: he said, ‘sometimes a fart is just a fart, Paul’.”

Whilst I laughed at the remark, I was ever so slightly pissed off that I looked like the one that was over-analysing. I mean, of course I do over-analyse, but oftentimes I am wont to dismiss psychobabble, and this was one such occasion. I’m not convinced he picked up on the derisive tone which nuanced my original comment.

As if to confirm this, he suddenly said, “sometimes it’s like you live your life in a goldfish bowl. Everything is there to be watched and examined, and there’s nowhere to hide.”

I snidely returned that if a goldfish was removed from its bowl then it would cease to have oxygen, wouldn’t be able to breathe, and would eventually die – thus, the goldfish bowl is a necessary place to be. Internally, I smiled at what I perceived as my clever comeback, and I looked at him with a smug and challenging expression adorning my facial features.

Right enough, he hadn’t planned for such a point, and was forced to concede it. It was desperately hard for me to hide my cocky satisfaction.

BUT! The man is too fucking quick for his own bloody good. After a few seconds, he ably destroyed my egotism by asking, “what about evolution, then? What if you don’t want to be a goldfish anymore?”

I resisted the urge to point out that merely wanting to evolve does not necessarily mean actually evolving, thinking I had already pushed my luck with my awkwardness. Instead, I went back to a more therapeutically pertinent form of dialogue. “This is the thing. If I didn’t want all this crap to stop, I wouldn’t be here – I would never have been here – in the first place. And I think things have changed a bit, or at least are doing so. Maybe I’m less of a goldfish than I once was.”

“It’s like there are two goldfish in two bowls,” he offered. “One gets its water regularly changed, and it’s well-fed. The other only receives the very minimum possible to keep it alive.”

“That’s self-inflicted,” I commented.

“Perhaps, but maybe when that fish was first hurt, it couldn’t deal with any more than that – it could only concentrate on its most basic needs of survival.”

“Yes, but it wants to deal with everything else now, and it’s brain won’t co-operate. That is so frustrating.”

“Interesting,” he said thoughtfully. “The fish still blames itself for everything. It forgets that it was hurt by abusers and is faultless in this regard.”

“I think its point is that other hurt goldfish progress to a level of not being hurt any more…Well, OK, not entirely – this kind of thing can never just go away. But said other fish somehow capably manage their lives, whereas this one does not.”

“Perhaps the best it can hope for is to move into a bigger, better tank with its healthier friend from the other tank, where that friend can take care of it. It won’t make previous events go away, but perhaps it could make them easier to deal with.”

This was striding into difficult territory for me, which I proceeded to explain to him. “This is a stupid thing to say, I know, but it’s so unfair. Surely people (or fish) who’ve been hurt the most deserve the most relief – and yet they’re usually the very ones that continue to experience the greatest pain.”

“It’s not stupid,” Paul replied reassuringly. “Of course the world doesn’t work like that, but it’s still unfair.

“One of the hardest things in this kind of arena is having to get clients to deal with the bereavement of it all. The pre-abuse person that they were – he or she is never coming back, and that results in a tremendous amount of grief.”

Something about the statement resonated deeply and painfully with me – probably particularly because I don’t really remember much from before it all started. I have no frame of reference of who I was, and who I ‘should’ have become. “Obviously I was always aware of that,” I told him, “but there’s something about hearing it here, in those terms, that’s really big.”

“Huge,” he nodded. “For some people, though, it gives them a reason not to bother with therapy. If I can’t give you your childhood back, what’s the point?”

An understandable but obviously fatalistic view. I said, “but recovery – insofar as that’s possible – is surely better than perpetual misery. Sure, tinges of regret that you can’t make it unhappen are inevitable, but…don’t you have to make the most of what you have?”

After a brief pause, I had to laugh at my own hypocritical optimism. I am the last person on Earth who believes in the ‘count your blessings’ response to depression and related difficulties. How crude of me to patronisingly bring it up in this context!

Paul didn’t respond directly, though. Instead he said that he felt that whilst we were still occupying the bowl of the healthy goldfish, we were at least looking over at the other one. I wasn’t, for once, trying to ignore it, and I could see through the stagnant water that permeated its enforced domicile.

It’s hard to articulate the kind of feelings that were bouncing around the room. As I told him, I was indubitably affected by the analogy and, presumably, aspects of transference and whatnot, but when he asked me to describe said effects, I found it exceedingly hard. I could hardly speak – not a first in therapy with Paul (so much not a first, in fact, that it could almost be described as entirely normal in that circumstance). After a lot of stuttering and idiotic gasping, I eventually concluded that I was sad. Perhaps grieving.

“I had DBT forced upon me once,” I complained. “One of the aspects of it is some old wank about knowing what you feel and accepting that. Accepting, I get – but knowing? There genuinely aren’t always adequate words to describe some of this stuff.”

He shrugged. “I don’t think we do always need to explain. ‘Sad’ is enough.”

After a few silent moments of apparent reflection, he added, “you know, ‘sad’ is big for you. It represents a transition from anger, which is incredibly noteworthy.”

I nodded, but felt no need to reply. We avoided each other’s gazes for another quiet few minutes, before Paul continued by stating that he felt that there was a “softness” to me in those moments.

Needless to say, whatever spell had been temporarily cast was suddenly broken. I was repulsed by the idea of appearing “soft”, and in horror begged him not to “say that”.

“No,” he protested. “It’s OK to be that here.” Pause. “Or is that a step too far for now?”

“No,” I robotically replied. “I’m being stupid.” Then: “I have this life narrative, I suppose. I’m a bit of a bitch, harder than a fucking coffin nail [anyone like Papa Roach? I think they’re utter shit, but I do love that lyric]. You know. Misanthropic, a miserable sod. That’s me. A bitch.”

“I don’t see any bitch,” he responded. “Would it be easier if I did?”

There was a long pause before I randomly asserted that I was a child in a woman’s body. I told him that I took very little responsibility for myself, that standard practice in adult domestic living scared the living fuck out of me (example). I admitted to him about the dozens of cuddly toys I’ve ammassed over the last three or four years, despite having almost no interest in them as a child (save for Mr Friendly, of course). I confessed to the childish little ways I will sometimes privately talk to A (though mercifully I’m apparently not entirely alone in my experience of this phenomenon – Maybe Borderline reflects on her similar mannerisms with her husband here. Though I am nine years old than her…).

“Well,” Paul said, with a tone of exculpation. “You had to live as an adult when you were a child…”

“So am I trying to somehow vicariously relive my childhood?”

“Well, you’re trying to reclaim what was stolen from you.”

He brought up the concept of regression, which he says is sometimes used in trauma work. He said, “I wouldn’t ever do that here. You have to accept the loss, whereas reliving it in a therapeutic context only succeeds in avoiding the reality of the here and now. You are an adult – but you have an unheard child inside you, and the ongoing challenge is to allow her to speak.”

“I do think we’ve made some in-roads there,” I replied.

“Yes,” he agreed. “And the thing is, you’ve consistently turned up here each week. On time. That alone speaks volumes.”

“I must be getting something out of it, yes. I’m way too cynical to have kept at it if I wasn’t doing so, and I’m hardly engaging in the process because it’s fun.”

“Indeed. You do appear to be able to see the value in what we do, despite its inevitable difficulties. And that in itself is therapeutic.”

And, I think, so it is. I know I’ve had something of a relapse recently, but revisiting this session reminds me that progress has been made. I am intending to return to Nexus in the next few months to attempt to advance that further, and despite the current bleakness of my world, I am reminded, sometimes, that hope can and does exist.