Crawling on all fours into the mental health community

Its the first working day in January, and I have an appointment with a community psychiatric nurse (CPN). She rang just before Christmas and arranged to come to the house for a chat. I was relieved at her choice of venue, as all I could imagine was going to a really Victorian hospital and never coming home. Although I am really quite frightened, I'm hoping that I might actually get some help.I get quite self obsessed and wonder whether I should dress up smart, clean the house. You know, make it all look normal.

I am incredibly unsettled and feel like I'm hopping from one foot to the other in fear and anticipation. When she arrives I swing between wanting to play down how ridiculously ill I feel and pretend I am ok, or, just spew forth the totality of my insanity and to hell with the consequences. I choose the second option.I just hope I don't throw myself prostrate at her feet and embarrass myself.

We do an hour long trawl through the glorious disarray of my past, and finish up with the most recent events including satans little helpers. I feel emptied out and exhausted. I'm not sure exactly what I expect her to say. Maybe something along the lines of, "You are fine and actually there is nothing wrong.Its all in your imagination". Maybe not.  She says I am experiencing severe depression, I am too ill to work and I need to see a psychiatrist in the next few weeks. Oh. So it is as bad as I think and having it corroborated by a professional actually makes me cry. Somebody understands me at last. I hadn't realised how isolated and misunderstood I had felt, and I cling on to the hope that there may well be light at the end of the tunnel. My CPN will see me every week until I see the psychiatrist. I ring my GP who signs me off for a month and I believe in my heart that 4 weeks will be all it will take to get me back on track.

I invite my new boss to my house for a work related chat. She smiles gently and tells me that it might be more like 4 months off work than 4 weeks. Its at this point I realise my, "Keeping up appearances" effort has failed miserably and everyone can see how tormented I am. I feel all withered and pathetic. She comforts me by explaining that its best I go off work now as I haven't really started doing any longer term projects, so I'm not letting anyone down. I am disposable and bonkers. SO, I am officially mentally ill and wonder whether I get a certificate of authenticity. You know the whole, "Well you don't look mentally ill" - well maybe I get a flashcard that I can whip out when people think I'm pretending or I don't match up to the mentally ill photo fit picture. I have joined a very special club.I am on my journey into the rabbit hole.

Juggling the balls of madness

I feel like I've been hijacked by satans triplets - depression, paranoia and obsessional thinking. Work has also become hideously stressful as there is a managerial restructure going on. People's jobs are at risk and all levels of personnel involved are having some kind of melt down. I'm caught between a rock and a hard place. I keep threatening to abandon ship and work in a cafe making tea and sandwiches. At least it wouldn't involve being exposed to the myriad of stress behaviours my staff are expressing. Some use aggression, some apathy, some are in hysterical despair and some just get another job. My job sharing managers are at eachothers throats too,  and I feel like I'm caught up in some kind of weird benny hill episode. You know, senior manager running, being ran after by middle manager, being ran after by staff - they are all flailing their arms about and wearing short skirts.Its decidely unmanageable and I seriously consider leaving.

I see my GP and tell her that the 40mg of Prozac is making me feel rushy and jittery. She thinks it may be too high and swaps me onto 20mg of citalopram. This should help the depression and the anxiety. I've not told her about the intrusive thinking yet as I keep thinking it'll disappear.  I also didn't tell her that I'd seen the same GP 3 times in a row with the kids, and I think she's monitoring me for social services.

I go for a job interview with another team at the local authority. Bizarrely, I am successful and hurl myself with abandon into the fire. The job is full time hours but its a great opportunity for me to get some new skills and  get away from the frying pan. And into the fire I go. In my first week I am corralled into a private office with some other staff members and we are all told that the job evaluation of posts is in. Its like waiting for the golden envelope to open with, "You're a winner" or "You're a loser". Every job has been assessed against a matrix point system and it bands you accordingly. My band, originally PO1 is now downgraded, yes you heard it right, downgraded to a post that carries an £8,000 wage decrease. I can't help it - I start crying, which also sets off two other members of staff. My previous post is unaffected, and my new boss says she would understand if I went running for the hills, back into the arms of Benny hill.

Now, with the gift of hindsight, I can see that I'd been going about things all wrong way. Obviously, when you are at war with the mental health demons, its not such a good idea to change jobs, work more hours and expose yourself to a huge amount of stress. I strongly believe that at this point in time I have lost perspective and am becoming lost amongst the chaos. I'm am definately not onto a winner. I am also starting to speed up. My intrusive thoughts become worse, my mood dips quite dramatically and I feel like I am being pulled along on a very swift converyor belt. I'm not in charge of the speedomentre and my thoughts start to become very fragmented and jumbled.

I start to worry about myself and know that at any point I'm going to crash and burn. I go to my GP and beg for a referral to the mental health team. I'm hanging on by a thread and although they think I'm not that mad, I know I am. Rigorous honesty has kicked in and I cannot keep up the pretense. I feel like throwing myself prostrate on the floor in desperation and begging for some sanity. That might call for a magic ambulance though, a liquid cosh and a soft square room with CCTV. I'll attempt to hold off completely abandoning sanity for a few weeks.  God help me.

I book some holiday for the Christmas period and hope that things will power down and ease off if I have a break. Choosing to ignore the terrible situation with the wage structure, the team do a Christmas competition which involves a guy dressing up in a wig and doing family fortunes, and the rest of us choosing silly names for ourselves and winning prizes. I feel that I am teetering on the edge for the whole event. My laughing feels maniacal, I feel giddy and then think I'm going to start sobbing in a heap on the floor any minute. I am completely out of control of my thoughts, feelings and mood. Its akin to being on drugs and out of your face. But its not exhilarating and I'm really not having a good time. I'm actually quite frightened. I'm hoping that its not going to get any worse. I actually want to be somebody else because being me is absolutely no fun at all.

Return of the beast

So, I've done the funeral. I can now try and start work properly. My previous job share partner and I have now reconnected as friends. I invite her to my house just before I go back to work, and apologise for coming up short as a friend and job share partner. She apologises too, for not handling it as well as she hoped. We promise to never job share again and to go shopping in Monsoon very soon (Seeing as I'm all skinny again).

Being armed with experience I now make sure I hand over work properly, stick to what I'm meant to do and accept that I am not super woman.I look shit in golden hot pants and a head band anyway.  My priorities are different now, and it will only be as unmanageable as I make it. Being someone with very little self esteem, I'm prone to trying harder than most people, or being a hideous people pleaser. I seek approval in most areas of my life as my deepest belief about myself is that I am rubbish at everything and people really don't like me, They just say that to be polite. For many years "NO" was not a word I would use in my vocabulary. So, I am learning to be crap every now and then and not being a martyr to the local authority cause. If its not done, I won't die and nor will anybody else. Its quite liberating. I even sometimes take longer than I should for lunch. God I'm a saddo!

Anyway, So I'm feeling ok and I talk to my GP about trying to reduce my dose of anti depressants. Although I've had a few family traumas, I've felt ok. I don't want to rely on medication to feel well, not if I can manage without it. I don't know quite what makes people so reluctant to take medicine. Maybe we have an innate sense of self preservation and self will that means we see taking pills as immoral and a weakness of the spirit. I also believe that we hold a deep sense of shame about mental illness. The image of the straight jacketed,  foaming mouthed lunatic is one that most people probably see in their minds eye. You know, Nurse Ratchet  and co. Electric shock therapy, sedated until you shuffle, or running around naked thinking you are Jesus. Admitting being mentally unstable is a brave step for most. You're never quite sure what kind of reaction you're going to get.

Anyway, we decide to do a "One day on, one day off" pill taking regime to see how we go, and if it feels ok,  we'll do a "One in three days" regime. I stay positive and try not to see every mood dip, odd thought or funny tingle as a problem. After a month I feel appalling. I am devastated and go with my head hung low, back to the GP who tells me to go back to 20mg.  After another month I still feel bad, and she recommends I take 40mg to try and improve my mood. I begin to feel very "Rushy" and jittery. Its at this time I start to have what is know as "Intrusive thoughts." I know what this is now because I have a psychiatrist. When it was happening, I thought I was really going mad, and that I actually might hurt myself.

"These thoughts – obsessions – are often frightening or distressing, or seem so unacceptable that you can’t share them with others. Contained within the obsession is an underlying belief that you, or other people, may come to harm. However absurd or unrealistic this belief, you can’t dismiss it or reason it away. It creates unbearable anxiety, and makes you feel helpless to do anything except perform the particular ritual which can rid you of the devastating thought." (Mind.org.uk/obsessivecompulsivedisorder)

It happens after dropping the children off at nursery one day. I pull in the drive and a visual thought enters my head. Its like a movie screen playing inside my head. Go and hang yourself from the light fitting in the living room. It takes my breath away and I feel frozen in panic. What the F**k is this????? I begin to cry and don't want to get out of the car. I am so anxious I am rigid in my seat. I have to wait a while for the panic to subside.

The conversation I had with a post natal depression support group comes back into my thought process. Post natal depression can trigger or exacerbate underlying mental health problems. I actually don't want to commit suicide. I want to be alive and well for a very long time, to be a wife and a mother. What the hell is this all about. My fear is that I might actually go and do it even though I don't want to. I don't even know how to tie a noose. Its all completely bonkers. I finally manage to get into the house. It takes almost all day for the feeling of unease to pass. I am praying that this is just a one-off occurrence and that I'm not completely losing my marbles.

The calm before the storm

So after what feels like a never ending period of depression, the clouds dissipate and the sun comes out. Feeling ok is truly a novelty. I don't cry at the drop of a hat. The children are gorgeous and even when they do tag-team tantrum, or take it in turns to whinge, I rise above it. I don't have to endure it like torture and hide for 5 minutes in the toilet. I don't have that self obsessed fear that its all going to end in doom. I tentatively hope for a full recovery.

Its during this period of time I decide to diet for the first time in my life. My spirit cannot soar with pilsbury dough boy thighs and bingo wings. I do an online diet that sees me eating 1500 calories a day, with only a few goodies allowed and one pudding a week. Fruit, veg and soft toilet paper are my new hobby. The first  two weeks I feel hungry all the time and get a headache.After a month I can fit in my size 12 combat trousers and I feel reborn. It becomes a bit easier as I get used to eating less. By November I'm pretty much a smug size ten. I feel well and confident again. I feel ready to go back to work and it all seems to be falling into place. I feel pathetically grateful to whatever force is keeping me happy.

My maternity is coming to and end and I decide that for the new year, I shall return to work. I'll do it part time, and this time I'm not going back pregnant. The reason I won't be, is that I have had a copper coil fitted under a general anesthetic. AS with birth where nothing gets out, apparently now, nothing gets in either. They tried to force it but everyone gave up.

So the second week of January my working life will begin again. I can now plan for Christmas and build myself up gently. Half way through December my youngest son gets a virus called Bronchiolitis. People with young children dread the months of December to February as they bring a myriad of nasty bugs that you have to fend off. Coughs, colds, ear infections, sickness bugs, croup, tonsilitis, chicken pox...the list goes on. We take him to the GP surgery where we are told that he should be seen at the hospital as his breathing is not good. I spend a night at the hospital with him and they send us home with the not so comforting, "He'll either plateau now and get better, or, he'll get worse. Time will tell." This fills me with fear as he is so small. We've got steroids to give him too. I feel very reluctant to leave hospital but understand why we aren't staying any longer.

Fast forward 12 hours. My husband is on a night shift, my eldest son is in bed and I've managed to get my youngest off to sleep. At 9pm he wakes up and he is so hot I can hardly touch him and he is struggling to breathe. I feel my stomach fall through the floor and I instinctively know that something is terribly wrong. I call NHS direct and through my tears explain the last 24 hours. She takes me through the questions to which I reply, yes his chest IS sucking in, he has got blue lips and yes, I think he is really ill. She tells me to stay where I am and says a paramedic will be with me in 2 minutes, to be followed by a blue light ambulance. I think he's dying and I am consumed with terror. Men in green and yellow ambulance livery pile into the house.I'm told to get my husband home as soon as possible. I ring him through the chaos as my son is given oxygen, and blood is taken from his finger. He's in a bad way and we have to stabilize him quickly and get him to hospital. My next door neighbour appears and tells me she'll stay at home with my eldest son and wait for my husband.Thankfully we've become friends following the insulted cat incident.

My husband arrives as we're getting into the ambulance. Wires and machinery are all over the place and my son is not really responding. We set off and the lovely ambulance man is calm, gentle but informative. He tells me we're going to a special room called the resuscitation unit and bypassing A+E. Half way through the journey, my son stops responding and the blue light starts screaming and I'm praying that God will not take my son. I feel like screaming and wailing but I can't. We arrive and he's rushed into a small area with so much equipment that I am horrified. He's given lots of medication and he looks tiny in amongst the technical area. I am rambling and suddenly get quite excitable. I think this is known as hysteria. After about an hour his temperature comes down, his oxygen levels improve, and his breathing is calmer. He will be ok. We get taken to a side room on the childrens ward and he gets a lovely little cot with a doughnut ringed pillow to snuggle in. He must be exhausted. He's still attached to the oxygen and will get regular pain relief and steroids. He also has to use a nebuliser. They can't tell me how long he'll be in hospital. Whilst he sleeps, I completely break down and sob uncontrollably. After I calm down I manage to ring my husband who is also petrified. He'll look after our eldest son, take him to nursery in the morning and then come to the hospital. There is a bed in the room so I am able to sleep for a few hours.When we both wake up I attempt to feed him a bottle of milk, but his cough is so bad, everything that goes in come straight back up. He's becoming dehydrated so they ask me to assist whilst they put a tube through his nose down into his stomach. He struggles and gags and I cannot believe that it is happening. Its a total nightmare.

If  I reflect on this time, some of my behaviour was not what I'd expect of a traumatised parent. I mean this in the context of mania. My hysteria in the resuscitation area, my agitation and aggression with nurses, and also going to get a hair cut. A few weeks previous to this catastrophe, my hair had started falling out on the hair line on my forehead. Now, in the hospital its clearly about an inch. When my husband comes he tells me to go for a walk and take a break. Our son is responding now and he wants me to take a few hours out. Your life is temporarily suspended when you're in hospital for a few days.Its like being in  a vacuum. Anyway, as I'm wandering about I decide to get my hair cut off. I ask the stylist to chop most of it off at the back and to give me a blunt fringe to hide the receding hair line. When I return to the hospital the nurses look at me with bemused expressions. Its out of character for a traumatised mother to go for a beauty makeover whilst her son is seriously ill in hospital. I also know this but everything has got a bit skewed. Yet again this is a period of severe stress and lack of sleep.

My gorgeous boy returns home after 6 days in hospital. He's been sent home with soluble steroids, an inhaler and instructions to keep a close eye on him. He will need to come back to the childrens consultant over the next year for regular check ups, and we are informed that he will struggle for up to a year if he gets coughs and colds. Quite frankly, we are overjoyed that he's made it through and we'll do everything we can to make sure he's ok.

I feel a little knocked sideways but rally over Christmas. The week before I return to work my grandad dies which means my first request on my return to work is to take a day off. Sometimes I wonder if I was a child murderer or a genocidal maniac in a previous life. The universe has a dreadful sense of humour and timing. Life does not wait for you to catch your breathe and regroup. It throws custard pies in your face as you run along the greasy path of day to day futility. Please let something nice happen.

Managing with two

I organise my life very much like a military operation. I try to have activities planned and places to go. It helps me to have milestones throughout the day. When things feel very dark, I can get through a period of say, two hours, and I know my babies are going to have a nap. I can then pass out, rest or do some housework. It is incredibly hard work and my husband is still working shifts. I see my GP every 2 months and have a chat about my mental state. Has it changed? Is it worse, better or no change at all? I very much still take it a day at a time. My mood is still erratic but the general mood is definitely still depressed.Thinking that you might be depressed for a really long period of time feels like a death sentence. Its like telling an alcoholic they can't drink ever again.

I often wonder if this is still just post natal depression or a totally independent mental illness that is nothing to do with child birth. The problem is, as I said before, Post Natal Depression can happen up to 18 months after the birth of a child, so unless you are ill for ages, everyone assumes you'll just get better in time, you know like in a year or so. Maybe even sooner. Everyone tries to stay positive but people move on. You aren't news anymore. People find talking to depressed people depressing.  I work very  hard at appearing happy.

Doing  the post natal depression calculations,  I have to wait until son number 2 is 18 months old before anyone might actually think I am more mentally ill than first thought. This means I could end up in general practice treatment for two or so years and feel rubbish. I set myself a target of a year to see if things have dramatically improved. You may think this is a long time, but I've already been ill for a while and I think I'm in for the long haul. My children are very young and my circumstances are stressful.One thing I am not is naive.

Its like being half a person. You function, look ok, sound the same, but for the majority of the time you feel like you are a commentator on your own life. You laugh at the right moments, but you aren't actually having fun. You go through the motions, but life just isn't full of depth and flavour. Its all a bit grey. Every now and then you have a sunny day. The Band Elbow sing about, " Pull[ing] my ribs apart and let the sun inside". You want to throw off the concrete tunic, heavy on your chest, that you have to wear every day. You are sluggish and work hard just to keep up. I am permanently tired.

I am also now on very friendly terms with bacon sandwiches and family bags of revels.Food tastes bland and sugary and fatty foods seem to hit the spot. As well as being slightly derranaged I am now getting a bit on the porky side and am no fun at all. I'm sick of myself.

And then suddenly, I start to feel a bit better.