What is mental illness?

I don’t know.

I don’t even know if it’s a real thing.

I follow a lot of mental health stuff on Twitter. Some days, I’ll admit, it’s too much: the barrage of bad news about lack of services; or the stigma; or the positive proclamations from others that feel so far removed from me. When I look at this stuff I sometimes ask myself- why? Why am I reading this? Is this a cult I have chosen to join? Always there is the underlying self-doubt – am I choosing to be like this?

It worries me. Genuinely concerns me. Perhaps as Radiohead say “I do it to myself and that’s why it really hurts”. I’m listening to The Bends a lot at the moment. I question that too: why am I listening to such depressing music? It’s like I don’t want to be better! But I don’t think that’s true. The music is soothing. I do try and listen to upbeat music; I even created a playlist called Going Up! I hardly listen to it though. Listening to upbeat tunes when I feel like this would be rather like asking someone with food poisoning to eat some lovely curry. It ain’t going to help. So I continue with the sad songs because they help numb the intensity, which controls and dials down the impulsivity. Basically it keeps me safe.

Or does it?

I am so confused about everything. Everything. 

This doesn’t feel like illness. It doesn’t look like illness, except when it does, but that’s not all the time. 

I can’t help but think if I was actually, really ill then it’d be different. I’m so confused I don’t even know what I’m on about. Maybe diagnosis and treatment? That seems quite key with physical illness but not so much with mental illness. 

But then, say I’m not really ill, why have I let myself lose so much: family, job, driving license? It doesn’t make any sense to me. Yet, and this is terrifying, there is a part of me that feels the worst is inevitable. I mean, half of me totally gets that the slowing down over train tracks thing was wrong, so wrong. The other half of me thinks it’s a lot of fuss over nothing. If I hadn’t told anyone about it then I’d still be driving and social services wouldn’t be involved. I guess my brain is processing the memory and has come to the conclusion that it wasn’t the act that was wrong; it was confessing it. Sigh. Does that mean I’m mental, I mean…mentally ill?  Properly? But yeah that fatalist part of me sees some future. It’s not a successful suicide. Rather I see hospitalisation for me. 

When Nora asked if I wanted hospitalisation I said the right, socially expected answer. I said no. Of course I don’t want to be hospitalised. But I kind of believe I should be although I kept that idea to myself. You see I sort of believe that I am going to break, that I need to break, before I can get better. I can’t break at home so I’m trapped into some kind of functioning. I spend my days and energy trying to hold myself together. Don’t break. Don’t break. Don’t break. The music helps. Zoning out helps. Mostly it’s the consequences for my family that stops me. The supermarket caused me a panic attack as I’m so scared I’ll lose it in there. It’s going to happen now! Run away! Run away fast! 

 But you know what? I want to break. I want to go bat shit crazy. I want to release out all of this that resides destructively within me. To scream, to smash, to cry and it be ok. To break.

Is wanting to do that mental illness?

I don’t know what mental illness is. 

I don’t even know if mental illness is real.

Am I crazy?

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More Crisis Team

I’m really starting to develop a bad taste in my mouth when I think of the Crisis Team (CT).

The first time I met them they came to the house and did an assessment on me. They asked me if I was going to attempt suicide. I told them 50/50. They gave me a leaflet and left. Funnily enough it was only about 10 days later I made a suicide attempt. Hmmm if only we could have seen that coming…

Next time I met them was when I was in hospital. I had to be seen by them and assessed before I could be discharged in case I was going to try suicide again. I had no intentions of trying again so that meeting was easy. 

Then a few weeks ago when I felt very unsafe I rang the CT out of hours. The person I spoke was very nice. She was patient and encouraging and actually seemed to want to listen to me. As I was safe for the rest of the evening she passed my details to the CMHT for a callback the next day which was a waste of time (Have you tried knitting? Are you fucking serious? Oh you are. Right. Yeah. Ok.)

Then I met a CT worker with nurse Nora last week because Nora was pretty worried about my behaviour. The CT worker looked nervous, terrified in fact. She said very little. She reminded me of the kids I teach actually – out of her depth. She tried to hand me the leaflet and I politely declined. She told me someone would come visit me at home the next day. They didn’t.

The day after that I did see the CT again. This time I was summoned to the mental hospital by a CT doctor (oooh! The doctor! It must be serious!). That meeting went so well that I sat on the bench outside the hospital crying my eyes out at the hopelessness of my situation afterwards. The meeting with her had escalated my danger level to critical but I couldn’t ring the CT as it was speaking to them that had caused it. 

The CT Dr had said that someone would call the next day. They didn’t.

The following day a CT worker did visit. It was so frustrating; to the point that I felt my bones had been replaced with buzzing electrical wires charged full of irritation. We spoke about managing the children over the summer holidays. I was honest and admitted that it would be challenging  but that we (husband and I) had a plan. I showed her the beginnings of the organisation chart which included childcare, holiday clubs, husband’s time off and help from family. The CT lady offered external help via social services. I declined saying that we could manage which was true.

Imagine my surprise today when social services ring me about the referral from the CT. What the fuck? Anyway the social worker had very poor English. She seemed to understand words but not whole sentences. For example when she asks what medication I’m on I tell her that I’m not on antidepressants because the psychiatrist said they won’t work for me. So she notes down that I am on antidepressants. Somehow she gets the idea that my inlaws are living with us. How? Am I so unclear? But I don’t correct her because again I am so angry and I don’t want to lose it at this woman who seems to have her own, entirely fictional narrative on my situation. She tells me she’ll have to open an enquiry. Fine, I think, she can find out all by herself how wrong she’s got it. Afterwards I begin to panic. She’s going to ring the CT and the Drs. Well, I’ve nothing to hide. Then I realise that she may talk to them about all the stuff that is, frankly, crap. They’ll assume that I’m lying, not that she’s wrong. Oh fuck. So now I have all this social services crap to correct which is all due to the CT.

Tonight I will ring the CT and discuss this farce; I’ll try and get some record taken of the truth. Fine, fuck about with me but not my kids. 

Thanks for the help guys! You’re absolutely top notch at crises: causing, obviously. 

 

Well done everyone! Great work!

 

This is a blip

Will I ever be ok?

They say I will.

They say this will pass.

I don’t believe them.

I get worse and worse and worse.

Deteriorating.

Unable to function much at all yet aware that there is further to fall.

I’m scared of the fall.

   
I’m so scared about dying.

I don’t want to die. 

Especially not in a violent, painful, bloody mess.

If I just knew that there is a future.

If I could just believe what they tell me but they lie.

This is a blip they say.

My whole fucking life is a blip.

  

No Hope

Hope left a long time ago. It frustrates the life out of me that people tell me I must have hope. Why? Why should I have hope? Hope only leads to disappointment. 

Hope died. Then she was cremated. Then the ashes were put in a sealed bomb proof box. Then the box was buried deep in the ground. Then a huge tree was put on top. Hope is gone.

I miss her. 

And I find it unreasonable that people want to pretend that Hope is still alive. She’s gone. 

Back in December 2015 when I visited the GP about my mood problems Hope was still very much alive. If you’d have told me then that a mere 8 months later she would be gone I wouldn’t have believed you. She was so strong.

They killed Hope with their assessments, waiting lists and shit drugs. And stupid things they’d say; about magic wands; or yoga; or how lucky I am; or what exactly do I expect them to do about it; well, they’d each finish Hope off a little more thoroughly. How could Hope survive such an onslaught? She couldn’t.

So Hope is gone.

But then…

As I was writing this my GP rang me, returning a call from earlier. It was a helpful conversation and, just as simple as talking to someone understanding, I felt a tiny seed of Hope return. Perhaps new Hope can grow? Now, wouldn’t that be a marvellous thing?

  

  

Normal, Real and Other Adjectives 

I can’t sleep so I’m writing this. A ramble seems likely.

Normal. 

Normal is an interesting word. It’s almost becoming frowned upon. No longer is it correct to say that someone isn’t normal. I mean lots of us still use it casually but it’s definitely becoming more taboo. “I mean, that’s not normal is it?” said in hushed, questioning tones. I get told off by Nora (my nurse – remember?) all the time for saying I’m not normal. She reassures me that I am normal and am just someone who is struggling a bit at the minute. Hmmm. That kinda sounds like crap to me and because I’m an awkward arse I challenge her on it:

“Well actually ok if you don’t like the word normal then can we accept that, if we surveyed the population, people like me would be in the minority? Otherwise everyone would spend time at the mental hospital and evidence shows that is not the case. Let’s imagine a bell shaped curve with most people under the bell bit. I am not like them. I am different to the majority. Let’s call that behaviour that is socially accepted normal. That’s not me therefore I am not normal.”

  
I feel quite guilty typing that. I really am a difficult sod aren’t I?  Ah don’t worry about it. Nora is made of tough stuff she can handle me! 

I’ve been having some trouble with night time hallucinations. Scares the bejeezus out of me. She told me it was normal. My face resembled angry meme guy.

 

Hallucinating? Not Normal! YARGH!

 
 It doesn’t feel very fucking normal. So next time it happened I wrote an email at the time. (Yes, I’m shaking my own head. Who does that?!). Here’s an excerpt of the email 

“It’s dark and too warm. I’m calm. I’m a little scared. I worry that something/someone will come for me. I’d call it god but it’s not God – I don’t believe in that. Same idea though. They’re going to come and lead me away to where I should be. I shouldn’t be here. That’s what the night time hallucinations/dreams are about I think: I’m supposed to lead myself away but where? The teenage self wants me to go with her, be with her somewhere and be one person again. She doesn’t like being cast out like this. If they come for me I won’t go because they’re not real. None of this is real. That’s why it only happens at night – the chemistry has got to be just right in the brain to see these things. If they come I mustn’t go. I wouldn’t. “

Apparently this is normal.

I disagree that this is normal. 

I agree that it is normal for someone with PTSD (which in fairness was Nora’s point but I was being purposefully obtuse). But that thing that I wrote above  – that belief  – doesn’t fit in the bell bit of the curve. Normal for PTSD is different to regular normal. I’m trying to get my head around these adjectives: normal, struggling, real, ill, damaged, dangerous, unsafe, complicated. My understanding of these words is a bit off. The context has changed. 

Fuck it. Who wants to be normal anyway?

I’ll be unique. Just like everyone else. 

 

Two Heads

I know it’s wrong but what can I do?

There are two versions of me: rational and emotional. Mostly they intertwine so that my decisions and thoughts are made by a back and forth between them. As my mental health has deteriorated these different parts of me have split apart. They are definitely apart now; two distinct personalities in one body.

  
And they argue. All.The.Time. I’m so fed up of them. Even writing this they’re squabbling. Which voice will be loudest? 

Usually Rational wins. She’s patient and considerate and understands consequences. Her arguments are always better than Emotional. Emotional is just that: a bundle of feelings. Uncontrollable feelings: excitement, gratitude, anger, self-loathing and the rest. Emotional approaches feelings in the same way as a child left unguarded in a sweetshop. Emotional picks up lots of feelings, latching on to them and then quickly discarding them in favour of another. Some feelings are favourites. When those feelings get  picked up they are held for longer, savoured. Emotional wants to gorge. Rational stops her but not without a fight. Like a tired parent I observe this exchange as if I’m a third party, whilst still attempting to convincingly participate in real life. 

Then the realisation hits: I am Rational and Emotional. That’s me. A new height of distress is achieved and Emotional and Rational begin squabbling more intensely and I just want them to stop. Please stop. Please. Please?
Sometimes I try and explain to an outsider – any other human will do but they never quite get it. I suppose they just see me as one whole and address me as such. The outsider converses with Rational. Inside I translate to Emotional telling her to be calm, shhhh! No one really listens to Emotional. Everything is about silencing her but eventually she can take it no more and she bursts out. Look! I am here! 

Right now Emotional is bursting out. Show them. Rational rolls her eyes and sighs – no, we’ve been through this a million times. It cannot be done. Yes, says Emotional, it can. And I wonder if we just let Emotional have her way for a bit – it might mean a bit of peace. Rational isn’t so sure. And me? I’m totally fucked in the head. I have no idea.

Let’s Talk About Meds Baby

Let’s talk about all the good things and the bad things that may be. Let’s talk abooooooout meds (and some sex too as per the song).

Firstly I want to make my position clear: I am pro medication. A masters degree in medicinal chemistry and 6 years working for 2 of the biggest pharmaceutical companies in the world has definitely made me Team Med. I think it’s important to point that out because if I didn’t I may give the impression of someone who is anti-medication. How can that be?

 

chem badge1

I would wear this badge because I do love chemistry. Very much!

Well, I’m talking those pills that everyone and their granny seems to have an opinion on: antidepressants. I’ll confess I didn’t learn much about antidepressants in my degree and I have never worked on an antidepressant as a chemist so, in truth, I was pretty ignorant of them. But I had my faith. My faith in pharmaceuticals.

I’ve been offered antidepressants loads of times over my life. Probably because I’ve been depressed loads over my life. Makes sense. I refused each time because my own belief was, in every instance, that there was an emotional reason for my depression – such as pregnancy loss for example. My understanding was that antidepressants worked on the chemical imbalance theory of depression (which is on shaky ground I believe currently in scienceland) and I didn’t think that was what I had. Instead, I was sad because something sad had happened and actually I needed help to manage that – not pills. That’s quite an ignorant view I realise now. In my defence I never actually realised I was depressed! OK that sounds pretty stupid now but then none of the doctors told me I was. They just offered the medication and I refused. And on we went.

I know a lot of people on antidepressants. Everyone does don’t they? I didn’t judge them. I was pleased that antidepressants worked for them. My faith in pharmaceuticals was untested and as strong as ever.

My GP offered me antidepressants again in December 2015 and I finally accepted. I was such a mess. I knew that trying to work through past trauma would mean that things would only get worse and I could do with every bit of support going. I was prescribed fluoxetine and had joined my Prozac peers. I felt disgustingly cliche.

I used the t’interweb and researched fluoxetine so that I was prepared. I wasn’t best pleased about possible weight gain and positively horrified that these meds may mean never having an orgasm again. Ever. (Just so you know that was the sex bit I promised earlier!!! Disappointed? Sometimes sex can be disappointing…ok, focus, back to it) That didn’t sound like a very happy pill. Hmmm none of the folk I knew on antidepressants had mentioned that one!

Anyway, I wasn’t put off. My pharma experience had shown me that actually information about side effects could be misleading and in fact most people, most of the time wouldn’t experience any problems. I mean, have you read the info that comes with paracetamol?! That stuff is lethal!

Quite soon into taking the flux my suicidality increased. I told myself it was probably just an early side effect and would pass. In hindsight it may have been the illness progressing. Who’s to know if it was drug or disease? And does it matter anyway? I had 2 good weeks on fluoxetine. For 2 weeks it looked like it was all going work out just fine. Well, you can guess it didn’t work out just fine can’t you? I became massively dangerous to myself: one day I tried to find the knives in my friends kitchen…that’s not good.

 

office-thoughts-meme-suicide

This was me. This is me. Well, not literally. I’m female but you know what I mean.

The big huge massive shock that came to me about antidepressants is how long they take to work. You’ve gotta give ’em 6 weeks. Dems de rools kid. In those 6 weeks your suffering can, and often will, get worse. What the fuck?! So after feeling crappy enough that speaking to a doctor is worth doing (and no one wants to make that appointment so you really have to be ill to do it) you get these pills which will probably make you feel worse and then after 6 weeks you find out it was all a bloody waste of time. The reassurance will be that it’s not a waste a time. Finding out what doesn’t work is important apparently. Not to me it wasn’t. But anyway. Then there’s the dose increase on the same med – give it another 4-6 weeks. That takes us up to 3 months with no improvement and, in fact, a deterioration! Yes that was a bloody shock to me because that is utter shit. I doubt ibuprofen would be such a big seller if it might stop your headache in 6 weeks but first it was going to make it worse but then depression can be life threatening so some sacrifices are worth it to get better.

I was cut up when fluoxetine didn’t work. I felt like a failure. My GP raved about the stuff. My friends said it was wonderful. The chemist in me had believed that the medication would work. I naturally assumed it was my fault. Stupid me. I’d probably not tried hard enough or focused too hard on the negatives or something. I was genuinely gutted! Thinking about my relationship with pharmaceuticals I couldn’t decide which of us had let the other down. It’s not you, it’s me. Or maybe it is you?

Still, I knew that actually sometimes finding the right med could be trial and error. I hadn’t believed it but I did know it. Citalopram was the next port of call. Yeah. That didn’t work. The crazy increased and that’s when I took my overdose. NEXT!

Then the psychiatrist said mirtazapine. He’d never met me so I couldn’t discuss it with him. Instead he proclaimed “Mirtazapine!” from on high and the GP was the mug left dealing with me face-to-face. I think it irritated the GP to be honest and I’m not surprised. I was pretty bloody irritated that night when I looked up the side effects of mirtazapine. It was another what the fuck?! moment. The side effects had not been explained which was kind of concerning.

At first I just refused to take it. Well, I say refused. It’s not like anyone checked! I just didn’t take it. As far as rebellions go it was pretty crap. I felt awful. I had stopped the citalopram so was without anything. I caved and took the mirt. Rationally I thought it was better to try it and get fatter rather than splatter myself over a train track.

I fucking hated mirtazapine. It was completely sedating. I was dizzy a lot. I suffered muscle weakness and aches. One of these spells came on when I was bathing my daughter. I felt I would pass out. That’s pretty dangerous. And it got worse. By the time I was on my last dose (4 weeks in) I struggled to move. It was horrible. There had been some improvement; I no longer wanted to throw myself in front a train. However, I was still suicidal, self-harming and acting on dangerous impulses. I did not feel safe. So, just like that, another one bit the dust.

Three antidepressants and 8 months later I had to accept that my faith in pharmaceuticals has been irreparably damaged. Perhaps we’ll be amicable and consciously uncouple rather than full on fall out.
10-biggest-antidepressant-problems-solved-722x406The thing that made me write this post is that I’m currently going through withdrawal. I have googled like a pro but I can’t find any straightforward information about mirtazapine withdrawal. I can find a lot of stories but none address my concerns. For a start the psychiatrist told me (through a nurse – we still hadn’t met) to just stop my 30mg daily. No taper. I was surprised given it goes against everything I’ve seen, including information on stopping antidepressants from the Royal College of  Psychiatrists but hey ho. He’s the doctor and he knows my specifics…allegedly. So I can’t find any tales that match my taking 30mg mirt daily and just stopping which can make this feel like an even lonelier ride.


Cold Turkey for Tea

It has been 10 days since I took any mirtazapine, any antidepressant at all in fact. I tried working out using half-life if I should still be feeling the effects but I realised my calculation was overly simplistic. I’ve been dizzy, weak, had nightmares/hallucinations, continually shivering with chills, crying and generally being useless. I feel awful. Tonight I couldn’t get the kid’s tea on. There was nothing in because I was supposed to go to the shop but was too weak. The guilt as they mooched about hungry. I could text my husband and he brought in chips. Chips served up with a generous side of mama’s cold turkey. I hate it. I had to lie on the floor today as I struggled to stay upright so my toddler played a game phoning for help for me. Heartbreaking.

I craved advice and reassurance. Maybe I could ask the psychiatrist? No way to get in touch with him and even if I did I don’t trust him. Maybe I could ask my care coordinator? She’d then have to ask the same psychiatrist. Pretty pointless. GP? What’s it got to do with him? Oh right, nothing. In conclusion I’m experiencing all this confusion with nowhere to turn.

And Finally…

I did actually meet the psychiatrist earlier this week for a medication review. His conclusion was swift: antidepressants don’t work for me. They’re not designed for my situation. I don’t have a pervasive low mood.

I wish someone had figured that out 8 months ago.

So that’s it.

No medication for me. The drugs don’t work. I still get the withdrawal though and now it feels a scary, lonely place. The same demons must be dealt with and now it will be done without my chemical backup.

Except… If I continue to insist that my existence is wrong then there’s an antipsychotic the psychiatrist can/will try. It was offered more as a warning – behave yourself or else it’s the quetiapine! This struck me as a rather strange turn of events. You see I used to work for the company who made quetiapine. I’ve sat in meetings being told about the global picture regarding quetiapine sales but here I was sat in an altogether quite different meeting. I can’t help but think that in our uncoupling the pharmaceuticals took me to the cleaners. On the plus side I’m free to still have orgasms!

 

The Magic Wand

If you’ve been trying to get help with a mental health problem then I am absolutely sure that you will meet some standard language along the way. There is, of course, the The Broken Leg Analogy   which will be used to help you try and understand that you are really sick and should take medicine and rest. That has it’s uses to be fair. However there is another beastie  you will hear quite a lot and it doesn’t feel very nice. That is:

“THERE IS NO MAGIC WAND”

This seems to be the go-to phrase when I really, really need help. It is staggeringly unhelpful and actually, a little bit offensive. Do patients of other illnesses get told that there is no magic wand? “Hey Ted, that’s the nature of cancer I’m afraid. There is no magic wand.” Lol? Brilliant. That statement is absolutely how to make a person who feels utterly worthless, contemptible and idiotic even worse about themselves.

I Get It, Do You?

I understand where this phrase comes from, I think? Basically there is a frustrated healthcare person who would like their patient to feel better. Unfortunately they don’t have the resources. They’re stretched to  capacity and more. They’re working their arse off to continually feel like they can’t do enough. I get it. Hey, I’m a teacher. That’s our life too. So, dear HCP I understand that you are (usually) trying your best in a shitty situation but I wonder do you get that I am too? So when you suggest things and I seem to be dismissing them without a second thought could it be that, in all honesty, right now, I genuinely really feel like those particular suggestions are missing the point? It could be that I have desperately tried to manage this black tidal wave on my own already? Perhaps I’m not being difficult for shits-n-giggles and, guess what, given that I’m not an idiot I actually didn’t expect to ask for help and be told that someone would be on their way with their magic wand. Did I? Do you think that of me? I hope not. The magic wand statement gets brought out to kill the conversation and make it perfectly clear that there is nothing that can be done. Bugger. Off. (But please don’t kill yourself).

But There Is No Magic Wand

OK. Let’s think about this. A patient has reached out for help against all their instincts. For me I pick up the phone because I’m a good girl and I know that the nice people have made me a safety plan and that is the procedure so that is what I will follow because I am good and want to get better. So, when I do pick up the phone to speak to yet another stranger about something that is deeply upsetting (e.g. I wanted to set fire to my arm the other day, there’s more too but that’s enough to give you a flavour), personal and embarrassing please, please remember that the voice on the other end is a person who is desperate and vulnerable. What can you do for them? There is no magic wand but there is always caring, compassion and empathy. Maybe you have that instead and maybe, just maybe, that’s what the caller needs until something more concrete is available?

Nanny plum

Nanny Plum has a magic wand and isn’t afraid to use it! 

Here’s the other quite sad reality: when people tell me there is no magic wand it triggers me. I feel even worse. I am stupid for thinking anything could be done; I am pathetic for not coping; I am worthless and a waste of their time; it is hopeless I will never be better. And I feel confused too. Really confused. I did what they asked. They said when I felt like this to ring but then I rang and they were cross with me and told me they didn’t have a magic wand. I don’t know what to make of that. My depressed brain feasts upon it and the derogatory language in my head escalates: You fool. You absolute fucking fool. Why would anyone ever want to help you? You are so pathetic that you can’t be helped and now even more people know it. What did you think was going to happen you disgusting idiot? Don’t you realise that there are people much sicker than you, coping with so much more than you and here you are whinging about your own, stupid thoughts. Oh boo hoo. Do us all a favour, stop wasting our time and resources. You know how but you’re too bloody incapable to do even that aren’t you?  And on and on and on and on it goes. Never stopping. Sometimes interrupted but always there.

Expelliarmus

HP1

Let’s lose the “magic wand” statement. Harry Potter knows how.

So, what can people say instead of  There is no magic wand”?  I don’t know. I’m sorry. Did you think I’d have the answer? I don’t have a….no…wait…stop – not saying that! With all the humanity and intelligence and compassion and empathy we do have though maybe we can just say the right thing for that person at that time? Perhaps it’s best not to make their cry for help sound like an unreasonable demand? I don’t know. I do know I’ve lost count of the number of times I’ve been told that phrase and I will also warn you that it cuts deeper each time I hear it.