Tag Archives: new psychiatrist

00:10 – ECT… has it really come to that?

31 Oct

Today I had my third appointment with new psychiatrist. I have to be honest and say I was utterly dreading it because the last two appointments with him have been extremely frustrating and of no help whatsoever. But lovely support worker came with me and when she first picked me up I was very very anxious, did not want to go, but after sitting talking to me and calming me down for about 20 minutes I finally got out of the car and went into the main hospital building.

I had gone over with her what I wanted to say to new psychiatrist today and just hoped that I’d both remember it all and get the opportunity to say it all. I can’t remember if I have already mentioned this here, but basically I had decided that if this appointment went as shite as the last two with him then I was going to ask my GP to refer me to see a different psychiatrist. I may live in the middle of nowhere with very little in the way of mental health support but I do believe there is one other psychiatrist that does cover this area.

So, bang on 2.30pm his door opens and he calls me through. I hesitantly walk through with lovely support worker behind me. We sit down and he asks how I have been since I last saw him. I took a breath and told him that my mood has remained flat the vast majority of the time, that there have been a couple and I do literally mean a couple of OK/good moments but really for… well… so long now I’ve lost count my mood is flat, I rarely find enjoyment in anything, my self harming continues, I have fleeting suicidal thoughts, my sleep is crap, even the very basics like having a shower and getting dressed and taking the dogs a walk sometimes just proves to be too much for me.

Yes, I know I went out for the first time in at least six months on Saturday night and ended up having quite a good time but I think that was mostly due to the amount of alcohol I’d consumed. I did not mention anything about the recent brief substance misuse because I don’t want that splashed onto my case notes again… and anyways… it’s over and done with now with no plans of any repeat episodes. I told him about the two visits to A&E for self harm wounds and stitches, I told him I am trying my hardest to plod on with my part time home based uni course but that I’m failing to concentrate and struggling with it massively. I told him that sometimes I hear a little niggling voice encouraging me to hurt myself but that I can tolerate it as it’s nowhere near as bad as when I was hearing several voices and hearing them constantly. In that respect I think the 750mg a day of Quetiapine (Seroquel) is still working.

He asked how I’d found the increased dose of 45mg a day Mirtazapine and again I told him that it was fine for the first couple of weeks but then I started having such severe physical symptoms of anxiety (when I truly thought my heart was about to pack in and ended up getting the ecg done) and how lovely GP had wondered if it was actually the Mirtazapine causing it as anti-depressants do take a while to build up in your system. So I told him my GP told me to go back down to 30mg a day and see if the anxiety improved and yes, the heart palpitations did stop and have continued to be minimal. But the ‘psychological’ anxiety, the constant worrying and fears are still very much present. Some days I’m so scared to even walk out my front door to cross the road and walk the dogs for ten minutes then other days I dope myself up on whatever anxiety med I can and force myself to face a potentially scary situation.

He then asked how I had found the Pregabalin (Lyrica) that he had prescribed last time I saw him as the plan was for me to use it on a long term basis for my anxiety and finally start to taper off the Diazepam seeing as I’ve been taking it daily for three years now. But I had to tell him that had been a disaster as well… that I didn’t realise it had the same/similar ingredient as Gabapentin which it appears I’m allergic to. So the two medication changes he made at our last appointment a few months ago were both unsuccessful.

This of course brought us onto the discussion of reducing my Diazepam and I firmly told new psychiatrist that yes I am willing to reduce but I am most definitely not doing it at the moment. I feel horrendous enough as it is without trying to taper off from that. To my surprise he did actually say that he agreed now was not the right time, especially not as we are fast approaching my two worst times of year – Christmas and then my little boy’s anniversary in February.

He asked what support I was getting from the mental health team and I quite honestly told him how utterly useless I find cpn#2. He asked why and I explained about her super structured way of working, her setting of agenda’s, her constant ‘positive goals’ and her reluctance to talk about anything that is making my moods low. However I did tell him that I am now top of the waiting list for psychology and have been given a provisional date of mid to late November for my first appointment. It’s the same psychologist I used to work with so in a way I am looking forward to going back to see her even if I don’t feel particularly convinced that this Compassion Focused Therapy bollocks is going to work for me.

So all in all it was actually quite a good session. I managed to get across to him that the two medication changes he proposed last time I saw him had failed, that I was not ready to taper off from the Diazepam yet, that my moods are low and flat, that I’m self harming again and having occasional suicidal thoughts, that I am generally struggling with life a lot, that I’m struggling trying to continue with my studies, that the only person who lets me vent is lovely support worker, that I find my sessions with cpn#2 useless, and some days I seriously do wish I just hadn’t woken up that morning.

His first response to all of this was to ask me if I thought I would benefit from going in as an inpatient in the bin for a while? I said no, that place makes me feel worse, trapped, none of the staff give a damn, the other patients are too stressful to be around, there are too many rules… just no.

His second response was the one that surprised and to be honest shocked me (no pun intended). He said that as he looked back over all my medication history for the past four years we have pretty much exhausted every med now. There really isn’t anything different we can try. We could maybe try new combinations of something but I have pretty much tried every anti-depressant, mood stabiliser and anti-psychotic and benzodiazapine there is. He asked if it’s my depression or my anxiety that is worse and I said both of them. The anxiety can be managed to a degree with medication, the depression is just constant, constantly ongoing flat crappy moods that for months and months and months if not closer to a year have just stayed shit. Every day is an effort, every week is an effort, some mornings I open my eyes and my first thought is “I think I might kill myself today” or “I wish I was dead”. But I don’t act on them because I don’t want to put my parents through all that heartache and frustration again. I carry on painting on these fake smiles and trying so hard to make everyone think I am coping. Although I did let slip to my Mum the other day that I had recently self harmed and had to go to A&E. The thing is I’m still self harming – first through cutting… then misusing substances… then drinking… now back to cutting again. I try to put on this persona of being someone in recovery but I’m so far from recovery it’s scary. All these people telling me how well I’m doing because they don’t fucking let me talk about how bad I feel, they insist on only talking about positives and therefore have a completely skewed picture of how my life really is.

So new psychiatrist says here is the plan of action: he will not make any medication changes at the moment (mainly because there isn’t really anything else we can try), he would give me a couple of months to start seeing the psychologist again and see if psychological input helped my mood in any way, he encouraged me to be honest with cpn#2 about what *I* need from our sessions (told him I’d already done that and got nowhere)… he asked lovely support worker if she would carry on seeing me and she said yes she would see me weekly for as long as I needed it, he encouraged me to try and open up to my family so they know I’m actually not coping that great right now and all these fake smiles are simply that: fake.

And then he hits me with it… “there is one other thing we can try but I’d like to wait at least six months before trying it as I only like to use it as a last resort… have you heard of ECT before?”

I sat there kinda shocked but nodded my head. A very lovely fellow blogger tried ECT some time ago and I read all her experiences with it with interest even though it didn’t seem to work for her. It is something that scares me a bit… I mean nobody really likes the idea of being knocked out, put into a seizure and having your brain zapped do they? It’s pretty hardcore stuff. Then add in the quite possible and quite likely short term memory loss. It’s not the most appealing of treatment options. But whilst he did reiterate that it would be a last resort I suppose it sort of shocked me that it was even suggested. He said it doesn’t work for everyone but a point has to come where we try and break this depressive and unproductive cycle once and for all… and maybe, just maybe ECT would be the thing that finally works for me. But like I say, he wants me to try a few months of psychology first and then review things again. He wanted to see me back in a couple of months but he is away for most of January so my next appointment is February 6th… five days before my little man’s anniversary so I’m bound to be in a super depressed state of mind next time I see him. Again, lovely support worker said she would come with me.

I can see that my life is not good at the moment, far from it if I’m brutally honest. Yes on the one hand I haven’t given up on the studying (yet) and yes I managed to travel to a new faraway place recently (doped up on diazepam) and yes I even managed to go for a night out on Saturday (full of alcohol). But then we look at the flip side: I’m self harming a lot although managing to keep it reasonably superficial at the moment purely to avoid having to go to A&E, I’m having lots of thoughts about ending my life, my anxiety levels are ridiculously high and out of control most of the time, other than that one night out on Saturday I have next to no social life whatsoever, no friends that I see on any kind of regular basis, a constant niggling voice giggling away in my head at how pathetic I am and fuck just a couple of weeks ago things became so desperate I put that shite back into my body for some sort of an escape. I feel unsupported apart from by lovely support worker, I feel alone, I feel miserable, I question the point of everything, I don’t cook meals or eat properly I just binge on junk food, I’m lucky if I shower a couple of times a week. Things are not good. And I can’t go on pretending that I’m OK any longer because I’m not. I didn’t want to admit it but there you go, I’ve said it. I just don’t want to worry my family so I keep it bottled up… but it’s getting really bad again.

I cancelled my appointment with cpn#2 for tomorrow because I just cannot face her “positive goal setting” bullshit… I left a message for her saying I had too much studying to do and couldn’t go and asked her to give me a call back to rearrange another appointment but to be completely honest I will probably cancel that one as well. What’s the point when I get no benefit from them? And now I know it will only be a matter of weeks until I start seeing the psychologist again maybe it’s time to just stop seeing cpn#2 because I feel like I’m getting nowhere with her and I just cannot work to her super structured approach.

Has it really come to a point where I need to give serious consideration to trying ECT? Could that be the one thing that just blasts my brain back to a state of normality so I can get on with my life in a happy and meaningful way where I actually want to be alive and enjoy my life? Could it break away from all these desperate little attempts of escapism? I don’t know… And I’m not going to give it much thought for the moment because it wouldn’t be happening for at least six months anyway. And who knows where I’ll be in six months time… Who knows if I’ll even still be here? The way I feel at the moment that is somewhat doubtful.

But if I’m totally honest with people, if I lay my cards on the table and admit to how bad I feel then I enter back into the conversations like those of today: talks of admission into the bin… talks of ECT… Do I want those conversations, or worse, for them to actually happen? No.

I just want to feel normal whatever that is. I just want to feel happy. I want to wake up and look forward to the day ahead. I want things to be easy and free and effortless.

And yet I also want to go to wherever my little boy is… wherever it is we go when our body has died and our soul has moved on… and well…. I guess I can’t really believe that I’ve ended up back in this place again. I’m scared… the feelings of things about to fall apart and hit crisis level feel imminent and I’m genuinely truly terrified of that happening to me again.

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22:02 – Friday already…

9 Aug

Wow, I can’t believe it’s Friday already. This week has gone by seriously quickly. Maybe that’s because I’ve actually gone out of the house and done things, time definitely goes slower when I’m in self isolation mode.

Yesterday I had my appointment with lovely support worker from rape crisis. It was a good session, some of it was spent with me moaning about new psychiatrist and about these Lyrica (Pregabalin) tablets. The other part of it was me trying in some round about way to explain that every time I think of sexually abusive acts that have happened in my life I always find myself somehow excusing them or looking for reasons to justify them. It’s easier, so so much easier to blame myself and hold myself responsible for them all than it is to admit to myself that several males have actually wanted and enjoyed hurting me, who got pleasure out of hurting me…. one when I was just a child. The fact it happened again in adulthood means yet again I somehow asked for it to happen and deserved it to happen. Lovely support worker tried to reason with me and told me it wasn’t my fault but… I just don’t believe her 😦

Today I went to my appointment with CPN#2 so that was our first appointment in 8, 10, 12 weeks… I don’t know, I do know it’s been quite a long time (again, my fault). So she had asked me to take my Compassionate Mind chapters in and she has said that she wants to get me to a place where I’m starting to grasp the basics and then hopefully the psychologist will be able to start offering me appointments again to do the Compassionate Mind stuff when it starts getting more in-depth. I arrived at the appointment and she said it was nice to see me and said “ok we have an hour, what would you like to use that hour to talk about?” I said I had a question: will I still continue to have CPN support when I start working with the psychologist again? Instead of answering me she wrote my question on a piece of paper. She then asked me what else I wanted to talk about and I said “I have a lot of concerns about the new psychiatrist, I don’t think the appointments have been helpful at all and I’m frustrated that after sending a long letter to him it appears to have achieved nothing”.

Again she wrote that down on a piece of paper. She asked if there was anything else I’d like to spend the appointment discussing and I said obviously I wanted to use most of the appointment to make a start on some of this Compassionate Mind stuff. Yes, she wrote that down as well.

She then turned the stopwatch on her phone on and propped it up against the window ledge so she could “make sure the appointment doesn’t overrun”. I hated it, every time I glanced at it I was getting distracted trying to work out how long we had left and the more I tried to think of the quick but concise ways to discuss my points the more I started going off at a tangent and forgetting what my point was. She said more than once “could you please stick to the point MCBL… this isn’t the question I have written down” Grrr. She annoyed me a bit today if I’m honest. She seemed to want to run the appointment as though she was following an agenda for a meeting. Once I’d finished blabbering on about my concerns of being discharged from CPN support once the psychologist returns and she repeatedly told me she didn’t know what would happen but did make sure she threw in the obligatory “we are pretty short staffed at the moment” line. She did say I wouldn’t be left completely on my own unless I made the decision to stop engaging with them. She then crossed ‘point number 1’ off the list and asked me what my concerns were regarding the new psychiatrist. I began to tell her about him wanting me to start on a drug that I really didn’t want to take and how I just can’t understand why the new psychiatrist wants to shake everything up when this is the longest I’ve gone for a while where I haven’t self harmed or been admitted to hospital. Although there’s been shitty days there have also been stable ones and I just don’t get why this new doctor is coming along and trying to change all that.

Her response was simply that I could ask for a second opinion if I wanted but that I’d probably find that all doctors are trying to get their patients off of daily benzodiazapines. I said to her I was now on a relatively low dose, I’ve been taking it every day for almost three years, I have no bad side effects, it helps me… why do they need to fix something that isn’t broken?!! So CPN#2 asked me what dose of Diazepam it is that I’m taking and I told her I was down to 16mg a day. She then tells me that this is not at all a “low dose” and even though I told her that GP had agreed it was a low-ish dose she started going on and on about 2mg or 4mg a day being a low dose and to be honest I don’t really know what else she had to say on the matter because I became distracted watching the numbers changing on the stopwatch phone app. I heard her saying something about how I could try writing him another letter but I couldn’t be doing with listening to her so I just said “lets move onto the compassionate mind stuff… I’ll leave the medication stuff to my GP when I see her next Friday” and she seemed quite happy to cross point two off her agenda.

So we move onto the Compassionate Mind printed out workbook. She has a copy and I have a copy. She asks me where I’d like to start and how much of it I’ve read. I hadn’t read any. I did plan to last night but I forgot. However she picked out an exercise – the body scan one – and asked if I’d like to do that. I actually remembered doing that one with the psychologist back in 2010/2011 when she was trying to get me to do the compassionate mind – sorry ‘Compassion Focused Therapy’ – back then. So CPN picks another bit and basically she read a couple of pages aloud and I read them in my head as she spoke. She then started talking about what ‘homework’ she could give me as she can’t see me again for almost a fortnight, so I agreed I would try and read through some of the first section of it and write down the bits I found easy to understand and what bits I struggled with. Then she got out her diary and we made an appointment for the 22nd August and I glanced at the stopwatch – it was up to 37 minutes – but apparently that is an hour in her eyes as she started getting to her feet and showing me towards the door. In honesty I found the appointment pretty useless in the end. I’m really starting to feel a bit fed up with the CMHT and it makes me not want to attend when I just feel no benefit from it.

I had a pretty quiet afternoon once I got home and have carried on having a pretty quiet evening. Tonight will be my third night on the new higher Mirtazapine dose of 45mg but I only really noticed that I had a bit of brain fog yesterday but it was less foggy today so I think my body is going to adjust to the new dose pretty quickly. Which is good, of course.

I don’t have anything planned for the weekend as yet, hoping it will stay dry so I can get out a good walk with the dogs up the hills for a while. I could do with some real proper exercise where I come home aching all over and feeling like I’ve had a good work out. Hopefully I’ll be in a mood to go be outdoors tomorrow and the fact that I’ve stayed in since 2pm today isn’t a sign I’m slipping back into self isolating mode.

We shall see……

19:28 – Lots of anxiety about these Pregabalin (Lyrica) tablets!

7 Aug

Yesterday turned out to be a good day. I finally took Mum for her belated birthday lunch and managed to travel around 25 miles and then get out once we were there and managed to go into a restaurant and eat lunch. We were in the restaurant for almost an hour before I started feeling a bit anxious and irritable so I paid the bill and we went for a little wander around the village shops. The rain had came on by then and neither of us had jackets so it was a good excuse to head back to the car and come home. As soon as we were back within a couple of miles of home the anxiety quickly began to calm down so I even managed to spend another half an hour in a coffee shop having a slice of carrot cake which was yummy. It was nice to spend a few hours with Mum and just have a proper chat about both the crappy stuff and some lighter stuff and we both agreed we should do it again soon. So I came home and had a reasonably relaxed evening in front of the TV but then a very restless night’s sleep where I just seemed to wake up constantly, it seemed as though every time I dozed off I woke straight back up. Really annoying and left me super grumpy and overtired today.

Thankfully I didn’t have much to do today. I had an appointment with lovely GP this afternoon and she wanted to have a chat with me about the Pregabalin. She’d received a letter from new psychiatrist regarding my appointment with him last week and he said he wanted to start me on 75mg twice a day and also increase my Mirtazapine dose from 30mg a day to 45mg a day. I told lovely GP about the appointment with new psychiatrist being a complete joke due to the whole 15 minutes it lasted, the fact that when I told him I’d been voice hearing again he simply shrugged and offered no opinion on why they’d came back, that he was still going on about me coming off the Diazepam and that he said I could be prescribed Pregabalin to help with anxiety long term. Lovely GP asked how I felt about it and I told her that the only information I knew about it was what I had read on the internet and that new psychiatrist didn’t even tell me what kind of drug it was, instead simply telling me to “try it, if you don’t like it then you can stop, if it helps you can stay on it”.

So lovely GP took the time to explain what type of drug it was and told me all of the common side effects but there was something different about the way she was talking to me, something I couldn’t quite put my finger on but she seemed kind of hesitant or a little concerned maybe about me taking Pregabalin. She said it was similar in make up to Gabapentin which I once tried taking as a mood stabiliser back in 2009. I only managed to take it for a couple of weeks, maybe even just days before feeling so suicidal and so on edge and a complete mental mess and was told to come off of it immediately. When she told me it was similar to Gabapentin I instantly felt my anxiety start to rise and I told her I’d taken Gabapentin and what a horrible time I’d had. She looked back on her computer to 2009 and found the notes that went along with it and said to me again that it was my choice if I wanted to try it or not but she really did seem like she wanted me to say “no I don’t think I do want to try it” and that was exactly what I felt like saying to her, but there was something niggling at the back of my head saying “what if this drug could really help you… what if it’s the one thing missing and with the combination of it and starting the talking therapy stuff, this could be the right cocktail for me at last…”

I tried to explain that to my GP and she said it was completely up to me, she would go with whatever I wanted. So I asked again what dosage new psychiatrist wanted me to start on and she said 75mg twice a day. I asked what the lowest dosage available was and she said the lowest capsule is 25mg so I said if I was going to try it I wanted to try it from the smallest dose possible and work my way up if I find it beneficial. So we agreed I would start off on 25mg three times a day and then I have an appointment to see her again next Friday and if I find I am tolerating it ok then we can increase the dose. The thing is that once I got home I sat and read the patient information leaflet and there are a LOT of potential side effects. Now I know this is the same with ANY drug even simple paracetamol has a long list of possible side effects and you would think that being on the maximum dose of a drug like Quetiapine that I wouldn’t give a second thought to potential side effects, especially when I know I have the lowest dosed capsules they make. But for some reason (more than likely because I keep having flashbacks of the Gabapentin experience) I am utterly terrified of trying the Pregabalin now. I haven’t given a single thought to increasing my Mirtazapine tonight, I know what side effects I might feel from that and none of them scare me, I know I’ll just feel foggy headed and a bit zombie like for a few days and then my body will adjust to the new dose. But I have sat here with the box of Pregabalin in front of me for a couple of hours now telling myself just to take one but something is really stopping me. Anxiety stopping me. How stupid is that – a drug that has the potential to really help my anxiety is actually causing me a hell of a lot of it?!

So I thought I had made up my mind that I would start with the increased dose of Mirtazapine tonight and let my body get used to that for a few days and then re-assess the Pregabalin situation, maybe by then I’d have built up the courage to try at least one capsule. But then I thought maybe it would be best just to start it tonight and deal with all of the side effects all at once from both meds.

Argh, I don’t know what to do I really don’t. Something is screaming inside of me to remember how horrendous those days taking Gabapentin felt and how stupid I felt when I was whizzing my way through internet article after internet article and reading how it was generally so well tolerated… how could I be in such an anxious and suicidal feeling mess when all these people were saying their side effects had been minimal?? Of course, I have since learned that all medications effect everyone differently. There have been drugs that I haven’t been able to tolerate for more than a few days/weeks/months which other people have said they experienced no side effects from and then there are other people who say to me now that they don’t understand how I can be taking 750mg of Quetiapine mixed with Mirtazapine and Diazepam and not feel like a complete zombie.

I said to lovely GP that I know the reason the psychiatrist wants me off the Diazepam is because it’s an addictive medication but I also said that sometimes the attitude of “if it’s not broke then why fix it” would make life so much easier. At the moment I am slowly but surely starting to get better with the agoraphobia. I still can’t leave my safety zone or travel on a motorway or go near any big cities or shopping centres, but my distance is slowly increasing so long as I know I will be on quiet roads to get to my destination and so long as I’m in a situation where if the panic becomes unbearable I can turn around and head for home right there and then. In other words any form of public transport is still way too much for me to even consider because I’m not in any kind of control over turning the bus/boat/train/plane around… whereas when I’m in a car a car can be turned around immediately. Anyway what I was about to say before I went off on that tangent was, I was telling lovely GP that in my opinion (and obviously I’m no professional) but in my own opinion I think the dose of Diazepam that I am currently on (16mg a day) is a relatively low dosage. And I cannot see what long term damage would come from me staying on that dose and carry on with my life how it is at the moment, some areas still very much a struggle and some areas beginning to slight improvements. Lovely GP nodded her head as if in agreement with me and just gave me one of her sympathetic smiles. I have also found out from my reading about Pregabalin online that it is a pretty expensive drug to be prescribed whereas Diazepam at the dose I’m on is pennies in comparison. It seems so stupid to me that when some bits of my life are kind of ok someone who barely knows me can come along and decide they are going to remove my safety blanket but offer to put me on an expensive drug with the potential for tonnes of unwanted side effects, that may or may not help with my anxiety all the while I’ve already been taking something for almost three years which I know helps. I admit I do have to self medicate with it sometimes and take more than my prescribed dose on particularly bad days, but then there are some better days where I don’t need my full dose so it all balances out. But as I said to lovely GP I know I’m not going to win the argument with new psychiatrist so if this Pregabalin stuff is my only option for long term anxiety management and the only thing he is willing to offer me then would I be foolish not to even try it even if the potential for a repeat of the Gabapentin experience is pretty likely to happen?

I really don’t know what to do and I suppose I’m not going to find out by sitting staring at the box, but I think for the next few days anyway I’ll just do the Mirtazapine increase and get adjusted to that. Hopefully in the mean time I’ll find the courage to at least try the Pregabalin… Then again I don’t even know if I want to find the courage because I’ve read so much about it and so many mixed reviews about how helpful it actually is for anxiety and there seems to be one common theme and that is that most people start on around 150mg a day but almost everyone seemed to need to increase, most people who it worked for said they didn’t get real benefit from it until they were in the 300mg+ range and another whole lot of people said it has a tendency to feel like it’s working and then just poop out on them after a month or two meaning more and more increases in dosage. Also it appears to be a bit of a bastard to come off of. Even my box of the lowest dose capsules says on the pharmacy label “do not stop this medication without speaking to your doctor”. The withdrawal process from it has been horrendous for some people, people who haven’t found any benefit at any dose and so are withdrawing from it completely and ended up with a whole new battle on their hands. I know coming off the Diazepam isn’t going to be an easy one but at least I can say it was worth taking all of this time.

OK I think I’ve rambled on quite enough now I see the word counter has gone over the 2000 mark! Argh I’m just really confused and feeling really anxious and just do not know what to do for the best. Maybe things will somehow become clearer through the next few foggy mirtazapine brain days… who knows.

Tomorrow I have an appointment with lovely support worker and then on Friday I’m starting this compassionate mind/compassion focused therapy bollocks with CPN#2. Must remember to do some reading from the workbook tomorrow night. On that note my stomach is rumbling and I think it’s time to think about dinner and try to stop thinking about all the if’s, but’s and maybe’s about these stupid tablets every two seconds!

Arghhhh!

*lets out silent scream*

Deep breath…

Focus…

Count to ten…

And…

Breatheeee

 

 

 

23:02 – Another week already…

5 Aug

And so, another week has begun. It’s Monday night and I’ve had a relatively quiet day just spent indoors mostly besides a few walks with the dogs. I’ve been feeling extremely close to self harming a lot today although I’ve stayed on top of it and haven’t acted on it (yet). There’s several reasons for this but I’m not really in the mood to talk about them at the moment (a lot of them tie in with Berry whose still bursting into fits of giggles), so I’ll talk about my weekly line up instead…

Tomorrow I’m taking my Mum for a belated birthday lunch (it was her birthday last week but this is the first day she’s had off work) and I’m feeling a little bit anxious about it. I suggested going to a nice little village I’ve been to a couple of times recently with best friend. It takes about 45 minutes to get there and the scenery is absolutely beautiful but it’s a big challenge to all of the agoraphobic symptoms. Even though the rational part of my head says that I’ve done it before so I can do it again, this will be the furthest I’ve travelled with my Mum for a long time. But she has been so good to me and I’ve been saving up for a few weeks so I could take her to a really nice (but pretty expensive) restaurant that sits right next to the water. It gets excellent reviews so I’m sure the food will be lovely but again that is another big test to me – both being far away from home AND having to sit and wait until food arrives, fight the anxiety off enough so that I can get an appetite to eat, sit and make conversation for an hour or so, take a wander around the little row of shops, then finally come back home. I’m going to leave the dogs at home so that I can use them as an excuse to get back home for. I don’t like leaving them for any longer than 3 or 4 hours by themselves so that will give us enough time to get there, have our lunch, look at the shops and get home.

On Wednesday I’m going to try and get an appointment with lovely GP. That will be almost a week since seeing new psychiatrist so I’m assuming he will have got a letter to her by Wednesday stating what medication changes have to take place. Going on Wednesday means it will be exactly two weeks before I’d be due another monthly prescription so that should work out quite well – it will give me two weeks of adjusting to the higher dose of Mirtazapine as well as seeing how I tolerate the Pregabalin. Then I can go back and see her two weeks later when I’m due my monthly prescription and we can decide if I’m happy with the new med adjustments or if I want to change anything. I have to admit I’m feeling a bit very apprehensive about adding a new medication into the mix. I know I’ve chopped and changed and increased and reduced a shit load of meds over the years but I’m always a bit phobic of them to begin with, convinced they are going to give me tonnes of side effects and leave me in such a state of panic that no med in my emergency stash will be able to calm me down from. I don’t know whether to just add on the 15mg to my Mirtazapine and take the full 45mg at bedtime – I currently take the 30mg all at bedtime, and I figure that way I can hopefully sleep off any side effects. As for the Pregabalin I don’t know if I should add that into the bedtime cocktail or take it in the morning. I pretty much take all of my meds at night to try and sleep off some of the zombieness that accompanies them. I guess lovely GP can recommend the best way to take them seeing as new psychiatrist didn’t bother his arse *rolls eyes*… So anyways, that is Wednesday’s plan.

Thursday I have an appointment with lovely support worker at rape crisis and I think that now we can maybe start getting back on track and doing the ‘work’ that I’m supposed to be doing there. Due to me not getting in touch with CPN#2 for so long, some of my appointments with support worker have turned into mental health type stuff and that’s not really what I’m there to talk to her about.

But Friday I have an appointment to go back and see CPN#2 so I’m going to dig out that compassionate mind stuff she posted out to me and make sure I read at least the first chapter before our appointment so I can at least sound as though I’m trying (even if I do think it all sounds a load of bullshit deep down).

So that’s my week ahead… exciting times eh?!

I want to try and get to sleep early tonight so meds have been taken and as soon as I finish rambling on here I’m getting straight into my pyjamas. I never know which is worse – wake up early and have time to get organised, mentally prepare myself for the anxiety I know I’ll soon be feeling, take some Diazepam, take lots of deep breaths, kinda ‘psyche’ myself up to it if you like. Or is it easier when I sleep in late, have to jump up and have a shower, get dressed, dry my hair, walk the dogs, feed the dogs, run out the door chucking some Diazepam down my throat – all of which done within 30 minutes of opening my eyes. Is it easier to take the time to mentally prepare or is it easier to just throw yourself in, very much at the deep end? I don’t know which is the best method, both have been tried and failed, both have been tried and worked. Sometimes I think the best way is just not to plan anything, that way you can never be disappointed in yourself. I try and tell myself I’m just going out for a while, just going to spend time with my mum or best friend or whomever, that I’ll be back home soon, there’s no need to panic, but sometimes the panic just laughs straight in my face then sucks me in, sends me crazy, then spits me back out as a quivering anxious wreck…

OK, on that note I’ll say goodnight. Fingers crossed that tomorrow won’t be too anxiety provoking and maybe I’ll even manage to have a nice time and enjoy spending a few hours just Mum and me. I want her to have a nice day so I really need my panic to behave itself and stay well away hidden in the background if only for a few hours.

Goodnight folks! x

17:10 – Pregabalin (Lyrica) for anxiety… anyone?

1 Aug

Sorry I haven’t posted for a couple of weeks, to be honest my head has been all over the place and I’ve been spending almost all my time self isolating recently. I still haven’t seen CPN#2 but I finally found some courage and phoned to request another appointment. I was only on the phone to her for about three minutes and all she talked about was how it would be beneficial if I could at least read the first chapter of the Compassionate Mind/Compassion Focused Therapy workbook thingy before I see her again. She said this is to prepare me for doing structured work with the psychologist but I have to admit I just sat here rolling my eyes thinking “what a load of bull” as she spoke. Anyway I said I would try and read some of it and the first appointment she could offer me won’t be until the 9th of August, so next Friday.

She didn’t ask why I haven’t been in touch with her for the best part of ten weeks; I did try to apologise but she just said “that’s your decision whether or not you want help” which kinda left me feeling like she thinks I’m not arsed about getting help from them. Of course there are some days when I’m not arsed, equally there are other days where I know that whether I like it or not I have to try this therapy stuff and just see what happens with it. The one thing that did confuse me though was the way she said I was working with her to prepare me for working with the psychologist – does this mean that when the psychologist finally starts working with me again that I’ll no longer have a CPN? I don’t know. It kinda sounded that way though. To be honest I obviously don’t feel much benefit from seeing her or I wouldn’t have let the past couple of months pass without getting in contact with her. So maybe that question answers itself.

Moving along to today and it was my second appointment with the new psychiatrist. I haven’t been sleeping great lately and looked like shit (felt like shit too with the combination of extreme tiredness and a bucket load of anxiety). My support worker came along to it with me which was a massive help because I felt more confident in talking about the points I raised with him in the letter I sent after meeting him for the first time. I told him about my concerns over stopping taking the daily Diazepam and how I understood that I cannot stay on it long term but at the moment it is doing something to help me and if he takes that away then there is nothing in it’s place to help me cope with the agoraphobic related anxiety and to a degree, social anxiety. I told him I’d also spoken to my GP about this whole coming off of the Diazepam stuff and how she agreed with me that it made much more sense for me to start the Compassionate Mind stuff and at least start learning the basics before withdrawing what is essentially my safety blanket. He didn’t say anything, in fact he barely looked at me. He scribbled some notes down and made the same comment as last time “you are only scared to withdraw from it because you are addicted” – well if I am addicted it’s the fucking fault of my old psychiatrist for leaving me on them for almost three years!!!

He asked about my social life (what social life??) and I told him I had been self isolating a lot lately and I told him I missed a few days of medication (twice) in the past couple of weeks and how disappointed it made me to realise that the voices were still there underneath the elastoplast band aid also known as Quetiapine.

I didn’t like my old psychiatrist much, I admit that, but at least he gave appointments that lasted around an hour not fifteen minutes. He would ask me about the voices, what they were saying, how they made me feel, how they affected me, what I thought they wanted, etc. But this new guy? He didn’t ask a single question.  He skimmed over my medications again then said he would agree to leave my Diazepam dose at the current level of 16mg a day for three more months before I have to start withdrawing and leave my Quetiapine at 750mg a day but he then said that he thought I was experiencing low moods and wanted to increase something to help me (Quetiapine is already maxed out) so he asked me if I’d like to move up from 30mg Mirtazapine a day to 45mg a day. I said I’d give it a go.

Then he said something which surprised me a little – he asked if I wanted something for the anxiety that I could take on a longer basis than any benzodiazapine? I asked him what he had in mind and the medication he recommended was Pregabalin. I told him I’d never heard of it before and he simply said just to try it and if I didn’t like it then I didn’t need to take it. This was another thing that annoyed me – the old psychiatrist would have taken five or ten minutes to explain what type of drug it was, what possible side effects there could be and answer any questions I had about it. This new psychiatrist, however, offered no information at all and simply told me to go to my GP next week and get a prescription for it, as well as for the extra dose of mirtazapine.

Of course as soon as I got home the first thing I did was consult Dr. Google about what the fuck Pregabalin actually is. It seems that it’s primarily a medicine for epilepsy, an anti-convulsant, which is also used for neuropathic pain (conditions like Fibromyalgia) but the more I read the more articles I came across for it also being an effective treatment for anxiety. I’m not sure what dose he is starting me on, I’m pretty sure he said 75mg but from all the reading I’ve done this afternoon it seems like most people need at least one if not two or three increases as a lot of people say it seems to lose effect after a while.

I’m apprehensive about trying it but if they are determined to wean me off the Diazepam starting October/November time then at least it gives a good period of time for the Pregabalin to build up in my system. I think the withdrawal off the Diazepam is going to take several months and I can’t lie, of course I would much rather stay on it, but I know I can’t, so if the Pregabalin works then that would be super.

I’m still experiencing bursts of laughter, uncontrollable giggles, and silly childish remarks off and on from little Berry but the voice of Sasha has well and truly gone. However I am still struggling a lot with urges to self harm. I’m on top of it at the moment but things do feel a lot like they are sliding backwards a lot of the time. Oh, that reminds me, I actually asked the new psychiatrist if he thought the voice hearing had come back almost like a rebound psychosis because I suddenly stopped taking my medications for a few days and he didn’t even answer me! I actually found him to be a little bit rude because I was talking about something personal and instead of listening to me he started writing me out another appointment card. At the moment I rate his communication skills as poor, his ability to display empathy or understanding as non-existent, and his 15 minute appointment sessions are just a joke. I know GP’s are limited to about 10 minute appointments but the ones with the psychiatrist are supposed to be anywhere from 30-60 minutes. Grrr.

I thought that by writing him a letter and explaining everything it would be beneficial to both him and me but now it sort of feels like a waste of time. Even though he wrote a short letter back thanking me and saying he understands my mental health better now. I don’t even think he remembered the letter until I mentioned it and even then I saw him flicking through my notes and speedily reading through it. Unfortunately I live in such a rural area that he is the ONLY psychiatrist I can see. I am very thankful that we have the NHS in the UK and receive free healthcare treatment but sometimes it’s extremely frustrating when you have to work with people who you feel no benefit from seeing but you carry on going to the appointments anyway because you know that if you don’t then you just won’t have a CPN/Psychiatrist/CMHT.

I think I have rambled on enough now but it would be great to hear from anyone who has tried Pregabalin for anxiety purposes (I believe it’s called Lyrica for my friends across the pond) and what you’re experiences of it have been – good or bad!

For now, I suppose I had better try and face the outside world and go buy some dinner for me and the doggies. Hope you’re all well xx

14:38 – Few things ticked off the list

4 Jul

I have so much to talk about since I last posted but I should warn in advance my head is all a bit choppy today. When I was writing my last post on here I was going to see lovely GP the following day which I did. She said she had taken the time to read my letter about being unhappy with the situation with new psychiatrist and that she understood where I was coming from. I told her I really don’t have a problem with knowing eventually the Diazepam has to stop but this just doesn’t seem the right time when there’s no other coping mechanisms in place.

I asked her out of curiosity what would happen if the psychiatrist said he wanted something to happen but she didn’t agree – I always assumed in this case that because the psychiatrist is a consultant and a specialist type of doctor that his decision would overrule a GP’s decision. But apparently this is not the case; lovely GP said it doesn’t happen often as it causes friction, but if she feels strongly that another doctor is recommending some wrong type of treatment that she would prescribe what she felt was the right choice. She said something about when I’m in hospital then the psychiatrist is prescribing my medication so in that case he is in charge. But when I’m at home in the community my GP is my prescribing doctor who writes the prescriptions so the final decision would be hers. Something knew I learned.

Anyway sorry I went off onto a ramble there – the short version is I got another monthly prescription with no medication changes. I also got my fasting blood sugars done because the symptoms I’ve been having could be from either (a) my PCOS causing insulin resistance/prediabetes (b) all side effects of being on the max dose of Quetiapine. The symptoms are very similar well the ones I have are: constant and I mean constant dry mouth and needing to drink liquids. Drinking between 10 and 15 pint glasses full of cold water or orange diluting juice. Still having a dry mouth. Constipated despite drinking so much water. A few other things as well. So lovely GP did a fasting blood sugar test and the result was 5.2 a little on the high side but not high enough to worry yet. Lovely GP also said she is referring me to go and see the gynaecologist as I haven’t seen one in about six years and I am contemplating asking to go back onto Metformin to help insulin resistance stuff and help lose weight but I have never been able to tolerate it as it makes you have constant stomach pains and cramps and running to the toilet. Sorry a little bit TMI there. So it should probably take around 6-10 weeks to get an appointment through but I think a catch up chat with a gynae could be a good idea.

Moving on from the appointment with lovely GP (I can fit a LOT into 10-15 minute visits!) I also got a reply letter from new psychiatrist. It was short but polite and he thanked me for writing, said he felt he understood me a little better now and told me we can definitely discuss all of my concerns at the next appointment on August 1st. So that was good to hear that he had actually read it and thought I was being at least some amount of rational with my explanations.

I decided to be big and brave on Friday and try and go to a new place. A new scary place to challenge the agoraphobia. I didn’t tell anyone because I wanted to do it alone and also if I failed then I only I needed to know that. It was a very scary journey with lots of stops and panics and on a couple of occasions tears from the physical pain the anxiety was causing but two hours later I had made it there to my destination and I was still alive. Just. I had one aim in my head and that was to find the body piercing studio and go and have my lip pierced. I used to have my bottom lip pierced right in the middle but I took it out a few years ago. This time I have got my bottom lip done again but to the side and in a way that I can wear a little ring or a bar. It’s pretty swollen at the moment and I need to wait at least 4-6 weeks for it to be healed enough to change the ring that’s in it. So I was very happy to be walking out of the body piercing place lip stinging in pain, terrified because I was so far from home, overwhelmed at all these shops around me actual brand named shops that I haven’t been in for years. I treated myself to a McDonalds which was a big mistake as I was so sick that night but I enjoyed it at the time. After about an hour I was starting to feel quite panicky and wanting to go back home but an hour was better than nothing, maybe I’ll manage longer next time.

I was supposed to go and see CPN#2 yesterday at 1.30pm but my sleep has been so bad lately. Literally waking every hour sometimes just for five or ten minutes, other times for hours. So of course I finally manage to self medicate enough to knock myself out around 4am and didn’t wake up until 2pm realising I was supposed to be at my appointment. I think that’s about six appointments I’ve missed now. I think I’m going to receive a shitty letter in the post in the next couple of days about me not engaging or her not going to work with me any more as I don’t attend my appointments or some shit like that. I should have just phoned and apologised but after making like six weeks of excuses even the truth just sounds like an excuse now. Plus she posted me out all this stuff to do with the compassionate mind program and I read a few pages and rolled my eyes and was just like … blah … this is a load of shit.

So right now some things are going ok-ish, mostly I’m sitting about doing nothing, but a couple of times I’ve set myself some new targets and achieved them even when they’ve been really hard work. Other days have been long and slow and I’ve felt so depressed from waking up to going back to bed again. But some things are ticked off my list now:

  • Sent letter to new psychiatrist about concerns
  • Received reply that was polite and respectful
  • Arranged for support worker to come with me to next appointment with new psychiatrist on August 1st
  • Travelled to a new place and stayed there for an hour
  • Got my lip pierced
  • Saw lovely GP and medication concerns are now gone a bit
  • Being referred to gynaecology to talk more about PCOS situation
  • Had diabetes test done and got results
  • One fuck up – missing CPN#2 appointment

So that’s not too bad for a week. I think I’ve done okay. I could do with socialising a bit and seeing people rather than spending all my time doing things alone but I kinda like being alone. I’m feeling really quite agitated today and I need a distraction that will work. I noticed a shop near my flat sells these things that are like painting by numbers but for adults and I’m tempted to go and buy one of them to see if I can paint something nice.

Okay I have rambled enough now. I need to sort out an appointment with CPN#2 again as my support worker is off on holiday for the next few weeks and I have no one else for support right now. But in a way I kinda like it this way. Just me myself and I. Me and my doggies. My little routines. Keeping the world out and just doing what I need and when I need. I would like my mood to stay a little bit more consistent though, it feels like it’s yo-yo-ing a little bit again.

22:22 – Just a ramble really

25 Jun

This morning I was woken up with my mobile phone ringing. Unknown number. I didn’t think it would be some pain-in-the-arse sales call so early in the morning so for once actually answered it. It turned out to be CPN#2 getting back to me after me leaving a message for her on Friday. I asked her if she had got a copy of my letter and she said yes but swiftly said it had gone straight into my file and I kinda got the impression that was the end of that conversation. She told me she had briefly seen the psychologist (that I’m back on the waiting list to see) and they had printed some chapters from the Compassionate Mind program workbook thingy. She then waffled on for a few minutes about what parts of it she would do with me – basically she is going to use our appointments to do the basics of it then I think they are hoping I will be able to get into more depth with it with the psychologist once I start seeing her again.

The phone call with CPN#2 seemed a bit strange somehow. It felt like she was being a bit off with me from the moment I mentioned the letter. I didn’t say anything about it on the phone to her other than to ask if she had got it. So instinctively this is making me think she doesn’t agree with the points I raised in the letter or that some of it’s content has been taken in the wrong way. Argh. And she was making a real point of talking about how our sessions from now on were going to be very structured with specific tasks, goals and aims. I suppose this is a good thing but I’m still very sceptical about the whole compassionate mind stuff and really am not convinced that it’s right for me. Then again, maybe she read the bit in my letter which clearly stated that there were ‘no non-medicated coping mechanisms available to me right now’ and decided if she tries to get me onto this compassionate mind crap then she can at least say she is trying to offer me alternative coping mechanisms. So I see her next Wednesday – can’t say I’m looking forward to it but I’ll give it all a try, I guess I’ve got nothing to lose.

I don’t know whether to make an appointment with lovely GP tomorrow or not. I need a new prescription as I’ve just got a couple left for breakfast time tomorrow. Lovely GP did give me a repeat prescription sheet last time I saw her 4 weeks ago so that I didn’t need to make an appointment every 4 weeks, but in light of the letter I sent and the proposed medication changes new psychiatrist has made, I’m now thinking it might be better and easier just to go and see her. Our GP surgery is so annoying though. Unless you want an appointment in a month’s time then you have to phone on the day you want to see a doctor first thing in the morning, usually the phonelines are engaged constantly and when you do get through to a receptionist you’re told “sorry but all the same day appointments are gone now”. Frustrating. But I have been waking up around 7am a lot recently (this is after not going to bed until between 3 and 4am am) so I haven’t been getting a great amount of sleep or any good quality sleep. Despite the lack of sleep it means I’ve got a reasonable chance of being up first thing and hopefully get a GP appointment without any problems.

I can’t tell if I’m feeling tired at the moment or just fed up. My mood feels a bit blah. Thoughts drifting towards self harming again a lot at the moment. Sometimes it feels like the days are going by too quickly, like I wake up and think ‘fuck, another day to get through’ but again, that might be due to the fact I’m only sleeping 3 or 4 hours a night. I wish I could go to bed right now – 10pm and sleep right through to 8am – that would be heaven. And it’s so frustrating when you just can’t seem to get your body to switch off and rest. My thoughts aren’t particularly fast though, they don’t seem speeded up in any way, if anything they seem slower than usual. Like every day is just one big drawn out frustrated grumpy thought that occasionally dips down into ‘horrible thought’ category then back to just being fed up and miserable again. It’s not like there aren’t things I could be doing – there’s plenty of things I could be doing to pass the time a little more productively. But I just sit here glued to the sofa or lying on my bed staring into space and thinking all the ‘what’s the point’ type thoughts but they are going in slow motion. Stuck like a broken record. The only breaks come when I think the dogs would probably like to go for a walk and even then it’s the same slowed down murky depressed thoughts in my head just with some fresh air around my face.

So I guess I’ll see what happens tomorrow and report back with what happens with lovely GP. Maybe I’ll just do the cowardly easier option and hand the repeat prescription request into reception and hope that she doesn’t cut the Diazepam dose down yet. But I would prefer to go and see her and talk in person, she’s one of the very few professionals that I can actually talk to quite easily yet for some reason every time I’m sitting in that waiting room waiting to be called through I start to panic like mad. Ah, you just can’t win sometimes.

OK I’m going to see if there’s any chance of getting an early nights sleep. Please let things go OK with lovely GP if I see her, I can’t be doing with both my psychiatrist and GP both disagreeing with my concerns over the whole Diazepam withdrawal, I need to feel like someone other than my support worker is on my side and right now it’s looking likely that CPN#2 is probably going to take the view of new psychiatrist. I kinda expected that anyway seeing as she actually has to see him and spend time with him when he comes here each week to do his clinics, obviously they’ll all want a nice little happy working relationship and if that means keeping your mouth closed for an easier life then that’s what they tend to do. That’s one thing I miss the most about the social worker I used to work with, she was actually one who would open her mouth and disagree regardless of what others were saying. She had balls. I miss having someone with balls in my care team. Then, on saying that, lovely GP is usually very fair so maybe she will actually agree with the concerns I have written down.

Right, 10.20pm, time for medication. Time to sit around and go back and forth from the bedroom until I finally pass out for a few hours… then just as I’m enjoying it my phone will start bleeping loudly in my ear and it all starts all over again.

17:29 – Letter sent to new psychiatrist and my week’s worth of rambles

22 Jun

So a few days have now passed since finding out I have the all clear, although it’s been weird, even after getting the results back on Tuesday the anxiety surrounding it all still took another day or two to settle down.

On Wednesday I spent a few hours with best friend and the kids and then got my hair cut and highlighted. It was getting really long again, a good six inches or so below my shoulders. Now it’s in a kinda choppy medium length bob, just sitting at my shoulders and the blond highlights all the way through are really nice. It’s strange though, best friend was like ‘look now you can tell CPN#2 when you next see her that you did something compassionate for yourself’… whereas in my head there was nothing compassionate about it… I wasn’t sitting there thinking ‘ohh I deserve this’ or ‘ohh my hair looks really nice’… all I could think was ‘my hair looks a mess, it’s far too long, I can’t be arsed to spend an hour or more straightening it, it’s time to get some chopped off’. The only reason I got the highlights was because there was a special offer on and whilst they look nice I still have that negative sort of view that the money could have been better spent on something else.

Anyways… moving along…

On Thursday I went to my appointment with my rape crisis support worker and we spent the session putting together a letter to send to new psychiatrist. I had my first appointment with the new psychiatrist on the 5th of June and as you may remember it was a disaster. I thought about writing a letter to him pretty much as soon as the appointment was over but decided to give it a week or so just in case I was overreacting and thought I would maybe calm down about it all. But whilst I have calmed down, I still strongly felt like there were things that needed to be said to him before I next see him on August 1st.

I’m not going to copy and paste the full letter here mainly because of the length of it but also because it contains a lot of personal/confidential information but I’ll cut and paste the main points I raised:

  • As soon as I entered the appointment the first thing you did was check you had the correct medication information for me. As soon as I confirmed it was correct you automatically said that you want me to begin reducing my Diazepam (which I have been taking daily since Nov 2010) with your reasoning being that it can be an addictive medication.
  • You did not ask me how I would feel about reducing my dosage, there was no conversation about it nor did you ask me which of my symptoms that I feel the Diazepam helps with. You didn’t ask how my mood states had been recently, or if I was still self-harming, etc. In fact it seemed to me that you had already made the decision that changes should be made to my medication before I even entered the room and before meeting me.
  • You said to me that because I am on a high dose of Quetiapine that I wouldn’t notice not taking Diazepam. I don’t understand this because it is my understanding that the two medications are used to treat two completely different conditions. The Quetiapine helps control intrusive voices, paranoid thoughts and beliefs and delusional thinking. It does not help with anxiety. I am also concerned that you mentioned lowering my Quetiapine dosage slightly as well, when I have only very recently began to feel a little more stable. This concerns me as I worry if the Quetiapine is reduced as well then I may start to have symptoms of psychosis again or destabilising my mood to the extent where I end up back in hospital.
  • My main concern of all is, at the moment, I do not have any other coping techniques for my anxiety and agoraphobia and self-harming. I am currently on the waiting list to see the psychologist, however have not had an appointment to see her as yet. I hope that in time I will learn tools to enable me to cope with my anxiety, agoraphobic symptoms and distressing self-harm episodes, all in a way that does not require medications like Diazepam. I want to be able to deal with these situations in a healthier way, but the fact remains that right now I do not have any non-medicated coping strategies in place to help me cope with the debilitating levels of anxiety that I experience. It just seems that it would make a lot more sense to: wait until I begin seeing the psychologist; start learning and putting into practice non-medicated coping skills; and then start to lower the diazepam medication.
  • I would also like to make clear that I do not object to the idea of lowering the dosage of the Diazepam slowly and safely and I would also like to make clear that I fully understand it is a medication that is intended for short term use. However I feel that reducing it before there are any alternative coping strategies in place would be a very risky thing to do.

The letter ended up being three pages long but those are some of the concerns I raised. My support worker printed me off a few copies and I wrote at the end of the letter that copies had gone to my support worker, my CPN and my GP. Well, every time they send me a letter about something or another they send it to everyone in my care team so I figured I would do the same. All the letters have been posted now and I do have a little bit of anxiety about what the reaction to it will be but I know that I have the support of my support worker and she agrees that I’ve done the right thing so at least I know someone is on my side. I did also say at the end of the letter that it was not a letter of complaint against the psychiatrist, it was purely me wanting to have the opportunity to explain my concerns after feeling unable to do so properly at the appointment with him. I ended the letter saying that I would attend my next appointment on August 1st with him, but hoped he would have read my letter beforehand so we could talk about my concerns in more detail.

So that’s another thing done and dusted, well for the moment anyway. Hopefully they will see that I am trying to be sensible and rational and take my concerns into consideration. I need a repeat prescription on Wednesday and was just going to hand the repeat form into the receptionist but I’m now thinking it might be better to make an appointment and go to see lovely GP instead. I’m curious to know if she will support what I have said in my letter. She is usually very fair and I have a feeling she will say that maybe it is time for us to start lowering the dose of the Diazepam but I also think she will agree with me that there needs to be something in it’s place so that I can cope with situations that I can currently only cope with through medication. I guess the only way to know what she thinks about it all is to go and see her.

Anyways… I think I’ve rambled on enough now about all of that!

Yesterday I spent most of the day with a friend and I also got an email from my university tutor telling me I have to get up to date proof of being in receipt of benefits to apply for my course fees to be waived again when we start back after the Summer holidays so I’ll need to get that sorted out next week. I also finally phoned the mental health team to ask for an appointment with CPN#2 after a good 4 or 5 weeks of not seeing her (not her fault, mine for not attending and ignoring her phonecall and letter) but she isn’t back in the office until Monday so I guess she’ll get in touch then.

Today (Saturday) I’m having a quiet day as the weather is crap and my flat looks like a bomb site. My washing pile was getting ridiculously high as I pretty much spent all of last week in such an anxious mess that I got nothing done. I’m having a day where I just want to laze around in my pyjamas, do some little bits of housework here and there, work my way through my washing pile, watch shit on TV… a lazy day in other words.

Mood wise I feel OK-ish at the moment. Every so often I have some little thoughts that creep into my head out of the blue and start me thinking that I feel like I need to self harm, but I’m managing to ignore them for now. Although I have checked my hiding places a couple of times just to make sure that there are fresh packets of blades there… just in case… Then I catch myself looking at my legs and the horrendous scarring and feeling kinda sick that those scars are going to be there forever. And a part of me wants them gone, wishes I’d never done them, etc… Yet another part of me is like, ‘well you can’t erase any of those scars so you might as well add some more’. So not sure what’s going to come of these thoughts/urges yet, I guess time will tell.

Right I have rambled on for wayyy too long. And the washing machine has just finished another cycle so time to get off my fat ass and go hang it up to dry. I’m also starting to get hungry so time to cook up some pasta I think.

Hope you all have a nice weekend folks xx

 

15:19 – Tougher than I thought

14 Jun

I have been really trying to keep myself busy since I last posted as the past few days have been tougher than I thought. I’m noticing that as soon as I don’t have something to do my head keeps wandering off to thoughts about the blood test results this coming Tuesday. I keep running through all the if’s, but’s and maybe’s, I keep imagining all sorts of things like how the doctors face would look and what she would say if the test came back positive. I wonder whether I should go on my own or take someone with me. I just seem to think think think, constantly running through every possible outcome and scenario in my head.

Yesterday I went to my appointment with my rape crisis support worker and she offered to come with me to get the results but then when I said it was Tuesday I had to go she realised she would be in another area at the time so she can’t come after all. I got a good bit off my chest in our appointment though and whilst I’m still terrified of getting the results, I think I’m probably also trying to mentally prepare myself for bad news. I just can’t allow myself to think “it will probably be negative” instead it’s like I have to prepare myself for the worst so that if I do get bad news I don’t fall to pieces.

So after my appointment I went to meet best friend and the kids and we decided to spend the afternoon together and go for some lunch. We went to a really nice place that felt like it was in the middle of nowhere, it was an old barn on a farm converted into a little restaurant with a kids play corner to keep them busy. After we had finished eating we got to pick some fresh rhubarb and collect the eggs the hens had been laying so it was a nice stress-free couple of hours as the kids were occupied and best friend could relax and chat without constantly having to tell them to behave. I decided to tell her about the HIV test on our way back home as the kids had fallen asleep in their car seats. She instantly offered to come with me and when I told her how worried I’ve been/still am she said I should have told her and not kept it bottled up. Anyway, at least I know now that she will come with me on Tuesday if I decide I can’t face going on my own and it helped again to get some of the worries off my chest.

We decided to take the ‘scenic route’ home and it took forever! Thankfully I had taken some diazepam in my bag because the road seemed never ending and consisted of a single track road that went on for about 20 miles but we couldn’t go faster than 30mph the whole time we were on it, plus the drop into a ditch on one side and the drop down into the water on the other side didn’t help lessen my anxiety. As we decided to stop off at a couple of places on the way home and we popped in to see best friend’s aunt for a while it ended up being 7pm by the time I finally got back home. Then of course I spent all of last night sitting here worrying myself stupid again.

This morning I had an appointment with the dietician but I didn’t hear my alarm going off and missed it so I’ll need to phone and get another one. I can’t remember if I already said this in my last post but I got a letter at the start of the week from CPN#2 asking me to make contact with her as I haven’t attended the last couple of appointments she’s given me. In fact I think that’s a good 3 or 4 weeks now since I last saw her. Needless to say I still haven’t contacted her.

Part of me actually feels like disengaging with the mental health team and just doing it alone as CPN#2 and my old psychologist (who I’m supposed to be seeing again in the near future) both want me to do this Compassionate Mind program. They both really believe that learning the skills that program teaches will help me live with less anxiety and be able to be kind to myself and soothe myself as opposed to harming myself. But I just don’t think it’s right for me, I have a really hard time in grasping the very basics and it doesn’t help matters that I have this deep seated belief that I do not deserve any compassion. So the combination of not wanting to do that work with them and the recent disaster of an appointment with the new psychiatrist last week both just leave me thinking I don’t want to work with these people, I don’t really want to see them, I don’t think I’m going to find any benefit from seeing them or from doing this whole being compassionate towards yourself shit. I am still planning on sending a letter to new psychiatrist to explain all of my concerns from our appointment but I want my support worker to help me write it (which we were going to do at yesterday’s appointment but then it was spent with me freaking about the blood test results).

Talking of the blood test results (again) I don’t know if I’m more pleased or scared that I have got through Tuesday, Wednesday, Thursday and now we’re on Friday so I really just need to get through the weekend now. Halfway through a long seven days. As soon as I’m finished rambling on here I need to go and get some food shopping done as my fridge and cupboards are empty. I don’t have anything planned for tonight so I’ll need to find something to do to keep me distracted and then tomorrow I need to get a card and present seeing as it’s father’s day here in the UK on Sunday. So at least I have some things to do to try and pass some more time. Hopefully the weekend will fly by for as much as I’m terrified about the results I really just want to know now one way or the other so I can deal with whatever outcome I’m given.

Right… ramble over…

Have a nice weekend folks xx

17:08 – So the appointment was a complete disaster

5 Jun

I know I only wrote three hours ago but I’ve been back home from the appointment for quite a while and I’m an anxious mess all over again and can’t seem to calm things down. So the hope is that I write it all down and maybe I calm down…

Everything was a disaster. I was almost 15 minutes late in getting there because when I tried to leave my flat I started feeling all dizzy walking down the stairs so I turned round and ran back inside. I then stood inside my front door trying to breathe properly and calm myself down a bit. My appointment was for 2.30pm and it was 2.35 by the time I finally left. Needless to say when I finally got there at 2.45 I was panicking again because I was so late.

I stood outside the room I knew he was in and tried to discreetly listen through the door to see if I could hear any voices. I was hoping he was running late so that he wouldn’t realise how late I was but no such luck. I couldn’t hear any voices at the door so took a deep breath and knocked on it. He opened the door and I apologised for being late muttered something about anxiety and took a seat. He looked at his watch a couple of times obviously trying to work out how long he could see me for which clearly wasn’t very long as I think I was in there for all of 15-20 minutes. So yes, I took a seat and he introduced himself to me telling me his name and that he would be my new psychiatrist. I asked him if he was temporary or permanent and he replied “hopefully permanent!” with a smile. The smile made me a little tiny bit calmer and I thought he seemed OK.

He asked how I was doing and how my moods were at the moment. I told him things were OK and I felt things were quite well at the moment. Something about his watch checking made me think he had only allocated me a 30 minute appointment space and that he had someone else to see at 3pm so I didn’t see the point in getting into a ramble about all the crazy shit in my head. Telling him things were OK was the easier option to take.

And then it all started to go wrong.

He said he just wanted to check he had the correct details for the medications I’m taking and the doses of each. He read out the little list “Quetiapine 750mg?” I nodded. “Mirtazapine 30mg?” I nod again. “Diazepam 16mg?” I nod again. He made an unimpressed ‘hmm’ sound then asked me how long I’d been on daily Diazepam for and I tell him at least two years. He immediately replies telling me that Diazepam is a “very very bad drug” and that I must come off of it. Cue another massive wave of anxiety. I feel myself start to shake a little and my stomach starting to go into knots. I tell him that things have only just started to settle down over the past few weeks and that I really didn’t want to take the risk of everything getting seriously bad again by playing around with my medications. He responded to this by telling me I’d only need to reduce by 2mg a fortnight and that I wouldn’t even notice because I’m on 750mg of Quetiapine. I butt in and say that the Quetiapine is to try and shut the voices up and the Diazepam is to help with the agoraphobic symptoms – it isn’t even to do with the Bipolar really. By this point I am becoming noticeably anxious and can’t sit still in my chair. He goes on to tell me that Diazepam is an addictive drug and that after being on it so long I will now be dependent on it and it’s because I’m dependent on it that I’m reacting that way at the thought of it being taken away.

So I sit and stare at the floor while he runs through other questions about mood states and asks how my physical health is, if I’m attending my appointments with CPN#2, if I’m getting out of the house and seeing people all of which I continue to stare at the floor and without looking at him making small nods or shakes of the head to answer his questions. He finished off by asking me if I had any questions for him and I looked up briefly to shake my head then started getting up to leave. He said that I looked like I was unhappy and asked if it was because of the Diazepam. I knew then I had two choices – I could continue staring at the floor and achieve nothing or I could tell him what I felt about it. I decided to speak.

“I understand that I can’t stay on Diazepam forever and I understand that at some point it’s going to have to be reduced and stopped, but I found it really hard dropping down from 20mg a day to 18 and then to 16mg. Right now things are bearable, although I’m not really seeing anyone I am managing to get out of the house. I’m scared that messing with my medications is going to knock me off balance again when they have only just settled a bit. I can’t help but feel like if something isn’t broken then why fix it? Can’t we just leave things how they are for the moment please?” I rambled…

He then went on to say that I am only scared to stop it because I’m dependent on it even if I don’t think I am, after all if I wasn’t “addicted to it” then I wouldn’t be scared about not taking it. I wanted to say that wasn’t true, maybe I am dependent on it to some degree but it helps defuse some of my anxiety which in turn enables me to get out and do more things rather than lock myself away 24/7 in turn benefiting my moods. It can also help sometimes with stopping a self harm episode or at least reducing the severity of it. Also it can be helpful with sleeping from time to time. The next thought that came into my mind was that for all the things I use Diazepam for I don’t have any alternative coping mechanisms learned, surely I need to learn other ways of controlling my anxiety and self harming rather than just whipping the safety net away and leaving me to crack on with things. I so wanted to tell him all of this in a calm manner but I was back to shaking on the chair and staring at the floor with no words coming out my mouth. He said he would be willing do compromise with me and make it be reduced by 2mg every four weeks instead of every two weeks to start off with and asked me what I thought about that. Before I could answer he carried on saying that 750mg of Quetiapine was also quite a high dose in his opinion and over time he’d be looking to reduce it down as well to see how I would manage with a lower dose… With hearing that I cleared the frog from my throat and my voice suddenly appeared back in my mouth.

“Look, I want to be honest with you” I said to him (knowing another ramble was about to spill out). “I really didn’t want to come to this appointment, I have spent the full morning having horrible anxiety about it and I sat thinking to myself earlier about what the worst thing that could possibly happen by coming here today would be. The thing that scared me the most was the idea that I’d come to this appointment and the new doctor I’d only just met deciding that they were going to change things about. I find it really hard to deal with things when I feel like someone is taking control away from me and I can’t do anything about it. And that exact scenario that was up there with ‘the worst things that could happen at my appointment’ has now just happened. You don’t know anything about me other than some bits you’ve read about me that another doctor wrote and you are telling me you are going to change my medications around when things are only just starting to calm down? Please can you just leave things how they are?!”

He looks at his watch again and agrees to leave things alone for now then said I had to reduce by 2mg but then says when I see him again on the 1st of August that I will be reducing the Diazepam by 2mg and I “have to understand that it is going to happen that way” whether I like it or not because the Diazepam “is a very very bad drug” for me to take. So I’m not actually too sure if I’m supposed to be reducing from now or from the 1st of August.

I decide then that there is no point in saying anything else, and that whether I like it or not he is going to take my safety blanket away from me regardless of how I feel about it.

It was a horrible 20 minutes and now I just wish I had listened to the anxiety earlier on and not bothered attending it but it doesn’t matter now anyway does it? He isn’t going to change his mind and I have to get used to the idea that he is the one in control of my medications, not me. So in case you couldn’t guess the appointment was horrible, I have taken an instant dislike to new psychiatrist as I’m sure he himself guessed when I stood up and left at the end without even saying bye. I’m not so much angry as scared that I might be more dependent on the Diazepam than I think and that I might have to face some horrible withdrawal symptoms – the main worry I have is going through rebound anxiety. I have a slight amount of anger that someone who has only met me for a matter of minutes and who knows nothing about me really can come along and just decide what I can and what I can’t take without taking into account how those changes in medication might destabilise my mood.

Well I guess I’ve rambled on long enough but I had to get all of that out while it was still fresh in my head to try and make sense of it all. Despite the appointment only lasting 20 minutes there was a lot to take in in that time. Maybe now it’s all out the anxiety will step down a notch or two. Well I can but hope.