Tuesday, 24 March 2015

Venlafaxination

It's been a month since I last posted but it doesn't feel like it. Every day seems to run into the next.  Time is passing, but I'm merely observing.  

It's very nearly a month since I started taking anti-depressants.  I was worried that medication would either cause catastrophic psychotic side effects or do nothing at all, but I was wrong.  How I feel is an absolute mystery to me - I know I have feelings somewhere, but they're so deeply buried that I can't access them.  Today I woke up and somehow knew that I should be feeling depressed for some reason, but I felt nothing.  Even more confusingly, I don't know how to feel about feeling nothing. 

Naturally, the reason I started taking an anti-depressant was to help alleviate my depression.  If that's the only valid factor in judging the value of an anti-depressant, then Venlafaxine is a miracle drug.  I can't argue that Venlafaxine hasn't fulfilled it's given purpose, but my depression isn't the only thing it's alleviated.  In the last month I've lost my sense-of-self. I can't think or feel, and, hence, can't go about life as I normally would.  My life now consists of sitting around the house, watching an appalling amount of TV.  I used to be incapable of watching more than 45mins of TV without getting bored and switching it off, but now I have no energy for anything else.  As well as not feeling myself I am constantly exhausted, my limbs feel heavy, my head aches, I suddenly come over hot and sweaty and I feel weak, dizzy and keep losing my balance.  These effects, I've come to know as venlafaxination.  

To be frank, I feel pretty damn awful, but I'm not sure if I relish it or resent that.  I feel so lazy and get annoyed with my lack of productivity, but I also feel like this is my comeuppance for trying to make myself feel better.  Maybe the universe is trying to tell me I don't deserve to feel well.  I know my masochism is the crux of the matter, but all rationalisations that my urge to self-destruct is not beneficial to anyone fail miserably. 

At the end of the week I'm due to see a psychiatrist who will consider increasing my dose.  I hope they whack it up so that the side effects will get worse and I'll suffer, but I do know how insane that sounds.  It leads me to question the reason I decided to go on meds again.  Was I really just hoping that they would give me psychotic side-effects again or did I actually hope they'd help? Surely you'd have to be truly mad to hope for a psychotic episode. 

Tuesday, 24 February 2015

'Professional' Input

(Health and Social Care Trust)
     

When I get a letter with this little sign printed on the top I get the heebie-jeebies.  Most often it's been a kind invitation requesting the privilege of using my arm as a pin-cushion, but today it was the kind I dread most - a psychiatrist appointment. 

    
I can't complain; I knew the letter was coming.  I made the appointment on the phone after grudgingly consenting to be re-referred to the mental health team, but now I'm dreading tomorrow at 2:30pm.  Everyone loves a psychiatric assessment...  

I've gotten to know the drill over the years and I know how to answer those couple of inevitable, all-defining questions without dropping myself in it.  


'Do you have any plans to harm yourself?'  
'No.'  If I did have any serious plans I'd have to be pretty stupid to tell you.  

'Do you feel you can keep yourself safe at the moment?' 
'Yes.'  No, I don't want to go to hospital. 

I'm pretty sure I'll leave the appointment feeling dejected and misunderstood, but whether or not I leave with a prescription is less certain.  I haven't been on medication for a year and a half now and although I never vowed to stay off it for life, I have my qualms about anti-depressants.  In the past medication has done me more harm than good.  I'm not saying that I don't believe medication can be helpful, but I've seen the zeal with which doctors are willing to medicate and have watched the deeply distressed become deeply zombified.  I've listened to professionals likening taking your anti-depressants to taking anti-biotics for the flu and have heard others describe them as 'mind numbing drugs' that just mask the problem.  I don't believe either opinion.  I think they're all wrong.  

The first anti-depressant (an SSRI) I tried gave me severe psychotic side-effects: visual, auditory and tactile hallucinations, delusions and paranoia.  The second anti-depressant (a NaSSA) did absolutely nothing and nor did the anti-psychotic that was added to try to augment it's effects.  Ironically, it's NaSSAs that I'd be dead set-against.  I was on the second medication for over two and a half years, despite being told that I'd only be on medication for six months to a year.  I don't want to be on medication for life.  If my camhs consultant had had her way I would never have come off medication at all.  After two weeks on a low dose of the SSRI I experienced more of an improvement than I got from the NaSSA in two years.  An SSRI would be a risk, but I've seen a little evidence that it might be a risk worth taking.   

If it were just an anti-depressant that I wanted I'd go to the GP and I'm pretty sure he'd prescribe me anything I wanted, but that's not the point.  I'd like the opinion of someone who knows what they're talking about and who is concerned enough to think about what the best option would be as opposed to just palming me off with the first drug that springs to mind.  If I don't trust the psychiatrist I wouldn't be inclined to take the medication, but then again, would taking an anti-depressant of any kind be better than self-medicating with paracetamol to take the edge off and risking liver damage?  

The real problem is that the professional opinion on the topic seems to be pretty dogmatic.  I want to make an informed decision, but I'm just a depressed person and my opinion therefore invalid.  I'm not hopeful.          

Saturday, 21 February 2015

It's Raining

I made this blog with the best intentions to post regularly and keep up to date.  Despite the fact that I always intended to blog predominantly about mental health, it completely slipped my mind just how debilitating a depressive phase can be.  

It's scary how quickly you can sink back to the lows that you thought you'd hauled yourself out of.  Sure, you feel yourself slipping, but it's just a bad day.  Okay, maybe it's a bad week, well, at a push, a bad month.  Before you know it you've drawn the conclusion that life is definitely not worth it anymore and are planning your escape route.  

Pretending what's going on isn't happening doesn't make it any less real.  Telling yourself you're fine when you're chest feels like an empty, soulless cavity isn't going to make you feel whole again. Your mood is like your internal weather.  How can you live in the midst of a storm?  

'If it's raining it's no good saying it isn't raining. Water is actually falling from the sky.' - Stephen Fry 

When it rains, it rains, but it can't rain forever.  No one can avoid the odd shower of sadness, but even the most depressive downpours will ease off in time.  

Moods, like the weather can be unpredictable, but nothing happens without a reason.  When the clouds are saturated with water vapour it rains, when positive and negative charges meet there's lightning and when air heats up and expands there's thunder.  What goes on in the atmosphere can be a bit of a mystery and so can what's going on in the subconscious.  

I'm beginning to put the pieces together and figure out why things got so bad, but the truth is it would have been so much easier if I'd opened my eyes to the situation before it escalated.  You mightn't be able to control the rain, but if you know the forecast you can at least have your umbrella ready.    

Thursday, 5 February 2015

Blog for Mental Health 2015




“I pledge my commitment to the Blog for Mental Health 2015 Project. I will blog about mental health topics not only for myself, but for others. By displaying this badge, I show my pride, dedication, and acceptance for mental health. I use this to promote mental health education in the struggle to erase stigma.”   



I mightn't have all that much experience with blogging, but I have had much more experience with mental illness than I'd like. 

Everyone has just about enough awareness of mental health to know of it's existence, but having a psychiatric diagnosis remains taboo. 'Let's not talk about that...'  This results in many painfully awkward exchanges, which, inadvertently, make it blatantly obvious that people actually are aware of the exact circumstances they attempt to claim complete oblivion to.  If you ask me, this elephant in the room scenario is the biggest problem in terms of mental health.   

Coming in at a close second to feigned ignorance is actual ignorance, which sometimes verges on arrogance.  With a lack of understanding comes inevitable misconception, which only serves to feed the stigma.  'Just pull yourself together' has become the stereotypical trademark of insensitivity towards mental illness, but there are countless variations of this, some more subtle, that are equally infuriating.  

Generally I don't hold it against someone when they make an unhelpful comment or offer extremely patronising encouragement because, until mental illness struck me, I would probably have been guilty of the same thing.  When professionals get it completely and utterly wrong, however, it can be incredibly demeaning. 

The view that only a certain kind of person is susceptible to mental health issues is wide spread.  In the eyes of the world, the criteria for mental illness are not to do with mood, state-of-mind or self-perception.  Mentally ill people are often thought of as lazy, under-achieving, unintelligent, badly dressed, unhygienic, dislikable or violent, but there aren't any statistics to stand by these speculations.  

In the four years that I've been in contact with mental health professionals, more often than not, I've been left frustrated.  My GP turned red when he was obliged to ask if I'd been having any more of my 'Erm... issues'.  I was told by a therapist that I self-harmed to get attention because people don't self-harm due to anxiety.  (This still bewilders me...)  I was told my depression would alleviate of it's own accord because I'm 'a nice girl'.  Doctor's were reticent to recognise there was a problem, despite me meeting all the diagnostic criteria, because I was well-dressed, polite and could hold a conversation.  When I was transferred to adult services on turning eighteen I met the regional consultant who asked me to tell him my history.  His response to which was: 'What?  Seriously?  But, you're... nice!'  Society has even managed to engrain that mental illness only affects a specific kind of person in people that spend their lives working in mental health care

It seems that no one is immune to the misconceptions flying around about mental illness.  The one thing I'm sure of though, is that no one is immune to mental illness.  In the same way that everyone has a body, everyone has a mind.  We all accept that our bodies have their weak spots; maybe a bad back, a sensitive stomach or a dodgy thyroid, but no one wants to accept that they have emotional weak spots too; maybe a tendency to catastrophise, to become paranoid or to lose control of their temper when things go wrong.  Just like no one is 100% physically healthy, no one is 100% mentally healthy.  If you have a mind, you have the potential to become mentally ill.  We all think that we are somehow personally exempt. 'It'll never happen to me.'  We're all wrong, but some of us will discover that the hard way. 

The stigma surrounding mental health is the biggest barrier to making progress, but that stigma is extremely difficult to shake off.  Every soap opera has an stereotypical psychopathic character and every time an abhorrent crime is reported in the media alongside the facts come conjectures about the culprit's mental health.  How many people form their opinion based on fact rather than fiction? 

Despite having been rather lucky and having always had professionals on board, the best widespread understanding of mental illness that I've come across has been online.  I've learned a lot more from reading blogs in the last couple of months than I've learned from listening to psychiatrists and reading NHS leaflets.  Real, relatable experiences beat clinical jargon.  They say it's all in the mind and it's true.  If people don't understand how their own minds work, what hope is there?  The answer to lies in listening to people, not just reading textbooks.  

The blog for mental health project is new to me, but has been running for a few years now.  There's a long way to go in fighting the stigma surrounding mental health, but I've found blogs to be an amazing resource.  Good blogs can be a little bit difficult to locate, however, but, for me, the Blog for Mental Health Project is has solved that problem!   

Friday, 30 January 2015

The Hour of Lead


The past week has been hellish.  At times I've been so numbed out that I didn't actually know how I was feeling.  All the while it was building up behind the floodgates, ready to knock me off my feet when I was least expecting it.  

The days have been long and void of emotion and the nights, thanks to insomnia, have been long too, but it's only then that feelings hit with full force.  Keeping up my pretence is my main goal during the day: if I don't my misery contaminates everyone else's life too.   As soon as the freedom to feel is reinstated and I shut my bedroom door in the evening, the floodgates burst open.  

I can't shut feelings out anymore.  I've gotten good at fooling other people, but I've not figured out how to fool myself yet.  My feelings swamp me completely.  I can feel a dull heavy pain building in my chest, dragging me down as if I'm drowning in my own emotion. It's impossible to change how I feel.  I can't change the fact that it hurts, but that's where the paracetamol comes in.  If I can't make it stop the next best option is to dull the pain.  In my foggy paracetamol induced stupor I'm not drowning anymore: I'm floating.  

Yet another unhealthy coping mechanism, I know, but, yet again, I didn't give a damn.  Why sink when you can swim?  I didn't think it was a big deal, so I mentioned it in therapy, but boy, did the shit hit the fan.  She rang my Mum, then I had to get my Dad to come in to talk about it.  By the time I got home the GP had been called and I got a phone-call from a doctor because it was too late to arrange an appointment.  He told me to go to A&E for urgent blood tests and re-referred me to the CMHT.  I didn't go to A&E and I'm not sure what I'll do when my referral comes through in the post. 

I think I'm beginning to give off crazy person vibes again.  I am apparently not making very good choices because I'm not in a very good place right now.  The medication mafia is on the prowl again and my therapist even asked if it's safe for me to be at home this weekend.  Other people making my decisions for me, putting me in hospital without my consent and insisting that I ingest a host of happy pills morning and evening didn't exactly 'fix' me last time. 

Living seems like a ludicrous prospect.  I'm sure I'm even suicidal - just weary of living.  I’ve experienced as many emotional ups and downs than most people do over the course of a lifetime.  I’m as exhausted as a one hundred year old.  I’ve lived enough now.  I broke down this morning, crying hysterically for hours on end.  I 
don't know what to do anymore; I don't know what I want anymore.
  
Despite how bad things are at the moment, I did see how much progress I have made after the hysteria began to subside.   This time four years ago I was trying to steal my antidepressants and diazepam from my Mum’s bag when she wasn’t looking so I could overdose, three years ago I was burning myself with my curling tongs, two years ago I refused to eat anything but some lettuce every 48hrs and last year I was abusing laxatives, binging and overexercising compulsively.  I’m not going to wake up tomorrow, jump out of bed and be full of the joys of spring, but I won't do anything to stop me waking up tomorrow.  I've outlived the Hour of Lead before, and I'm going to do it again.  I'm not exactly sure how yet, but I'm going to cope somehow.           


Friday, 23 January 2015

The Narcissistic Parent


It's about secret things. The Destructive Narcissistic Parent creates a child that only exists to be an extension of her self. It's about body language. It's about disapproving glances. It's about vocal tone. It's very intimate. And it's very powerful. It's part of who the child is. 


This isn't a conclusion that I would ever have drawn of my own accord.  My therapist suggested I look up a particular  Facebook page about narcissistic mothers, so I typed the term and hit search with bemusement, preparing myself to laugh aloud as the page loaded.  I didn't laugh.  I cried. 

Some of the posts crossed the boundaries of narcissism, in my opinion, and entered the territory of pure sadistic abuse, but then I came across an article about the more subtle characteristics of narcissistic mothers, which evoked memory after memory.    

Everything she does is deniable.  Apologies don't exist.  When she knocked my iPod onto the floor and the screen smashed it was my fault for 'leaving it in the way', i.e. on an otherwise unoccupied flat surface where she often leaves her phone.  

She rarely says right out that she thinks you're inadequate.  Many of her putdowns are simply by comparison.  'Doesn't Jennifer just ooze confidence!' 'Isn't Luke so funny.'  'Isn't she so clever.'  'You always were grumpier and more selfish than your brother.' 

She will carefully separate cause (your joy in your accomplishment) from effect.   'You got 98%!  What happened to the other two percent?'  'I can't be bothered with parent-teacher interviews.' (Listening to people talk about how well I'm doing at school is a burden...)  

She'll spoil your pleasure in something by simply congratulating you for it in an angry, envious voice. *sarcastic tone* 'Well done'/'Very good'  'What do you want? A medal?' 

Criticism and slander is slyly disguised as concern.  'It's a good thing you didn't go to uni this year.  I mean, look at the state of you!  You're a mess.  I'm just so worried about you...'

She violates your boundaries. You feel like an extension of her. 'She'll have a small americano.'  'Naomi doesn't like capers.'  'She wouldn't like anything like that.'  (All in Naomi's presence, might I add.) 

Any attempt at autonomy on your part is strongly resisted.  'You can't do work experience in the city!  You're depressed.'  'Are you sure you can manage?  What will you do about food? - It's all going to be covered in oil. You shouldn't go. You'll never cope.' 

Your accomplishments are acknowledged only to the extent that she can take credit for them.   'I practically did your transfer test for you!  Remember those practice papers we did?  It was really me that got that A.' 

*At ED support group* 'Naomi's doing really well with food at the moment.'  Cue responses: 'You must be such a great support to her.'  'Having family on side is clearly makes a difference.'  (The only time she ever acknowledges my eating habits is when she's screaming at me/trying to threaten me with another hospital admission.) 

She will be nasty to you about things that are peripherally connected with your successes so that you find your joy in what you've done is tarnished.  'Does that mean I have to take you in to school for the high achievers photo?  Ugh...'  

If you complain about mistreatment by someone else, she will take that person's side even if she doesn't know them at all.  'You've always been selfish.'  'You're so awkward.'  'You're not exactly easy to love.'  'Well, it's not like you're anything special...' 

Her feelings, needs and wants are very important. On telling her I felt suicidal when I was fourteen and didn't know what to do: 'How could you be so selfish!  If you cared about me at all you wouldn't say anything like that!'   

She is insanely defensive and is extremely sensitive to any criticism. 'I didn't do/say that!'  'It's not my fault!'  'Just blame me, why don't you!'  Cue door slamming, feet stomping and huffing.  

She makes you look crazy.  'You just being oversensitive.'  'It wasn't anything to do with me.  This is your problem.  You're the one in therapy.' 

She's envious.  'You're definitely no better than average looking.' (I was thirteen and asked if I looked was okay for the school disco because I'd used make-up for the first time.)  

She has to be the center of attention all the time.  'Do you know what seeing you like this does to me?'  'You being like this [mentally unwell] just makes me want to run away from everything and never come back.' 

She projects.  'Why haven't you done any sewing today?  It's not like you've got anything more important to do.'  (She was in fact the one who didn't move from the sofa for 4hrs when she said she would go to the shop to get groceries...)  

She blames. It took four years for her to conceive my brother because 'You never slept' i.e. she wasn't ready to have another child because she wasn't coping well with the emotional demands. 

'You were always so clingy...'  Recently she admitted in therapy that found it hard to separate from me when I was younger.  

Almost all communication is triangular.  'I'll tell Naomi.  You wouldn't want to upset her when she's already depressed.'  'You know how your Dad isn't good at talking about things.  It'll be easier if I talk to him on my own.' 

She will melt into a soggy puddle of weepy helplessness when she's confronted with unavoidable consequences.  'It's all my fault.'  'I feel so bad.'  'You know I'm always here to support you.'  *Cue monstrous guilt on my part* 

My mother is a narcissist, but that's not necessarily the most difficult part of it.  The reason she acts like this is because she feels inadequate and has low-self esteem.  She's not outright manipulative or cruel, just thoughtless and lacking a sense of worth.  How can I justify being angry with her for doing something that she does unintentionally?  

Now that I'm becoming more aware of this, I can physically feel the anger rising up inside of me every time she criticises, patronises, blames or compares.  It would all be so much easier if I didn't have to endure it everyday, but, living in the same house, I don't have much of a choice.  I wish I could move out, but I'm not a student and I don't work, so I just don't have the means.  I still struggle to cope with my depression and eating disorder, so it's not all that advisable to move away from home right now because my parents are the only people I have.   

There are some things she has done that I struggle to forgive, but I feel overwhelmingly guilty for blaming her.  How could you tell your eight year old daughter that she will never get married or have children because she's too selfish?  How could you tell your thirteen year old daughter that she's a selfish bitch when she comes to you in floods of tears because she feels suicidal and doesn't know how to make the feelings stop?  How could you sit down beside another human being who is hysterically upset without even asking if they are okay and strike up a casual conversation about the price of diesel?  I know she does these things because she has issues dealing with emotions, but it infuriates me that all these little comments, that she has undoubtably long forgotten, are engrained in my mind forever and have helped make me into the person I am.  Indirectly, my mother, the person who is supposed to love me and protect me unconditionally, has told me that I'm unlovable, that my unhappiness isn't worthy of notice and that my suicidality isn't a big enough deal to warrant any kind of recognition, never mind help.  

It hurt then and still hurts now, but I know she will never change and I will have to live with it 24/7 for the time being.  Somehow I have to change the way I deal with it in order to be well enough to move out and look after myself, but I have no idea how.  Right now I'm really struggling to see a way out.      


(the referenced article: http://parrishmiller.com/narcissists.html)

Saturday, 17 January 2015

Emotion vs. Education

Sleep and I are becoming progressively estranged.  Being awake gives way to thought, and that is where my problem lies. Sleeping is the only time I get a break from my brain.  If I could lie awake with my thoughts switched off for eight hours I could happily deal with the maleffects of sleep deprivation.  

As it gets later, darker and quieter in the house, the sense of impending doom begins to rise.  I lie awake, picking holes in everything.  By the time it's 3am my whole life has fallen apart at the seams.  If I were twenty years older I might be convinced I'm  having a mid-life crisis.  

There was a time when I thought I knew what I wanted, but everyday drags by and managing to crawl out the other side is a struggle.  I wonder if I'll ever crawl out the other side of this illness.  I wonder if taking this year out will make any difference to my mental state.  I wonder if it would be better to die now and save myself the misery of the next sixty years.  

Last night I thought that my mind was going blank and that I might finally be drifting off, but something in me made me jerk upright and start to bawl my eyes out.   

People have odd ideas of what brings happiness.  If happiness was earned in terms of achievements and material possessions, I ought to be pretty happy.  When it comes to books and exams I'm not stupid and I'm far from a failure, but what do I actually get out of any of it?  I've wanted to go to university for as long as I can remember, but what would the degree that I have an unconditional place on actually offer me?  

The one and only thing, that I can think of, that would make my existence seem worthwhile would be being able to make someone else feel like the most precious thing on earth.  You can't give anyone anything more valuable than the feeling that they are of infinite worth.  You could argue that people are in more desperate need of food, shelter and clothes, but I've had them all and have found myself refusing to eat the food put in front of me and wondering the streets barefoot, crying.

I could go and do my degree in Chinese and Russian, but I'm starting to question the value of academia.  What good will my being able to speak foreign languages do the world?  I haven't got anything worthwhile to say, even in my native tongue.  

Can I do a degree in how to love please?  Or even a personality transplant would probably do the trick.  Whichever's easiest. I'm not fussed.