There are lots of power struggles in any relationship and balance is a finely tuned thing. When you take your vows you mean them but it's not until they are tested that you really begin to understand the impact of "In sickness and in health". You don't plan for a major illness and probably naively think it'll happen when you are both really old or happen to someone else.
When it happens it tests your resolve and the depth in which you made your commitment. I think when I first got ill we both assumed I would take a few tablets and I would be back to my normal bouncing self but we were horribly mistaken. 7 years of treatment later we are still living with the impact of my illness and I am still ill at times and not completely cured.
Decisions that we used to make together had to be made by my partner as I was demotivated and unable to think straight. He would do more of the housework as I was so tired I would need to sleep lots. He had to play with the kids more as I couldn't keep up or have the emotional space to deal with tantrums or hissy fits. And this would happen in patches of a few months at a time and it's exhausting for everyone really. I would get better and things would return to normal but the fear of relapse and more months of stress would be lurking around all the time and noone could relax properly.
Being ill for me makes me feel very disempowered. I get confused really easily, my memory is atrocious and everything takes more effort. My self esteem, or lack there of, compounds my lack of confidence, so normal tasks become very difficult. So then I give in and let my husband do more. It's ok to ask for help. But then I get resentful that he is being all controlling and doing everything and I am no longer the independent female I once was. It's almost like forgeting what you've learnt and feeling that you might never get your skills set back.
The feelings improve as the depression improves, but then what can happen is the behaviours that stepped in to deal with the crisis remain in place between husband and wife. The balance is still tipped in favour of the carer. And the patient for want of a better word feels that they are being treated like an invalid when they aren't. It's infuriating and a fight to get back to the balance that once was in place. More talking and negotiating has to happen, again. I often wonder if "normal people" have to work this hard at doing marriage.
Thursday 4 July 2013
Wednesday 3 July 2013
Wifedom
When you first get married you think that nothing much will change except your name, but in reality everything changes. The first year feels particularly odd as you get used to being a Mrs, signing your name differently and getting attached to your new family permanantly. I remember my now mother-in-law giving me the "Do you know what marriage is about" chat, leading up to the wedding and telling me she thought I wasn't the marrying type. She still denies ever having the conversation, but I remember it all too clearly. So yes, you get yourself legally attached to someone and I did the whole fluffy dress, church, cake etc affair. It was lovely but rained like a monsoon all day. We went on honeymoon to Italy and had a lovely time and didn't want to come home.
My depression up until this point had not affected our relationship at all. I'd been well for a long time and it had never really come up in conversation. However I took a job in London and things took a nose dive. The travelling was a nightmare and the people I worked for didn't like me. I'd come from working in the voluntary sector and had a totally different outlook on how to treat customers, how to go about work in general. I lasted a year but not without going to counselling as I felt bullied and taking prozac for 3 months. I left and went back to the job I had come from but as a temp just to get myself in to a happier place. And things improved, I was feeling well again. We then decided to move from where we were living and travel up to the east midlands for my husbands work, and as the final decisions were being made I discovered I was pregnant. We were thrilled and it only took a month of trying. We were also incredibly shocked.
So we moved and 6 weeks later I lost the baby. We'd gone for the 12 week scan only to find out the foetus had stopped developing at about 7 weeks. It was awful sitting in the waiting area with all of the happy pregnant people. We were devasted and so were our families as we had already told them the news. Noone really new what to say, but what I didn't want to hear were plattitudes. I didn't want to be consolled. I wanted to be left alone. But we recovered. It took some time though and eventually we ended up moving to Leicester and trying again. This time it took 2 months to get pregnant and 6 months of paranoia to be a happy pregnant person. The rest is history ... well on the blog it is, you can read it for yourself.
But thinking about this information in the context of my mental health, I'd been under a lot of pressure and stressful situations leading up to the birth, and so had my husband. Relocating, bullying at work, miscarrige, relocation. Yes 2 relocations. It's not suprising that my head went really. But mental ill health changes you. You have to relearn how to be, how to act, how to cope. And this means how you interact with your interpersonal relationships, my husband being the primary relationship.
My partner in the last 11 years has been through a lot seeing me losing the baby, struggling at work, becoming the depression shell (It's called the retarded state when you just sit and exist and don't speak etc). He's feared for my safety and made me promise not to kill myself. He himself has had stress related condition but has also had lots of support not only from his family but from a lovely organisation called rethink. He has a carer who sees him regularly so he can off load and get a different perspective. They sent him on a mental health education course for 12 weeks and it really helped him to meet other people who are carers for the mentally ill.
And on top of this we still try to be a normal couple. Try to keep parenting , try to keep communicataing, trying to be supportive of one another. It's very tricky at the best of times to navigate a relationship let alone with all of the baggage we've got. But he feels I am not the woman he married and wants me to be that person again. But that time has passed and I am now moulded differently to how I was before. I am still me but my condition curbs my optimism and means I have to watch for stress and tiredness the whole time. My weight is an issue as I am chubby now instead of svelt, I need to chill out more regularly and go to bed early. Its called sleep hygiene. I have to take care of my spiritual and emotional well being too. It's a lot to do every day just to stay on top of things but it takes practice. Lots of practice. And keeping talking, talking, talking. Not arguing but processing and working things through. If you want to keep a marriage in any fit state you have to work hard at it. And I guess we do. Most of the time anyway.
My depression up until this point had not affected our relationship at all. I'd been well for a long time and it had never really come up in conversation. However I took a job in London and things took a nose dive. The travelling was a nightmare and the people I worked for didn't like me. I'd come from working in the voluntary sector and had a totally different outlook on how to treat customers, how to go about work in general. I lasted a year but not without going to counselling as I felt bullied and taking prozac for 3 months. I left and went back to the job I had come from but as a temp just to get myself in to a happier place. And things improved, I was feeling well again. We then decided to move from where we were living and travel up to the east midlands for my husbands work, and as the final decisions were being made I discovered I was pregnant. We were thrilled and it only took a month of trying. We were also incredibly shocked.
So we moved and 6 weeks later I lost the baby. We'd gone for the 12 week scan only to find out the foetus had stopped developing at about 7 weeks. It was awful sitting in the waiting area with all of the happy pregnant people. We were devasted and so were our families as we had already told them the news. Noone really new what to say, but what I didn't want to hear were plattitudes. I didn't want to be consolled. I wanted to be left alone. But we recovered. It took some time though and eventually we ended up moving to Leicester and trying again. This time it took 2 months to get pregnant and 6 months of paranoia to be a happy pregnant person. The rest is history ... well on the blog it is, you can read it for yourself.
But thinking about this information in the context of my mental health, I'd been under a lot of pressure and stressful situations leading up to the birth, and so had my husband. Relocating, bullying at work, miscarrige, relocation. Yes 2 relocations. It's not suprising that my head went really. But mental ill health changes you. You have to relearn how to be, how to act, how to cope. And this means how you interact with your interpersonal relationships, my husband being the primary relationship.
My partner in the last 11 years has been through a lot seeing me losing the baby, struggling at work, becoming the depression shell (It's called the retarded state when you just sit and exist and don't speak etc). He's feared for my safety and made me promise not to kill myself. He himself has had stress related condition but has also had lots of support not only from his family but from a lovely organisation called rethink. He has a carer who sees him regularly so he can off load and get a different perspective. They sent him on a mental health education course for 12 weeks and it really helped him to meet other people who are carers for the mentally ill.
And on top of this we still try to be a normal couple. Try to keep parenting , try to keep communicataing, trying to be supportive of one another. It's very tricky at the best of times to navigate a relationship let alone with all of the baggage we've got. But he feels I am not the woman he married and wants me to be that person again. But that time has passed and I am now moulded differently to how I was before. I am still me but my condition curbs my optimism and means I have to watch for stress and tiredness the whole time. My weight is an issue as I am chubby now instead of svelt, I need to chill out more regularly and go to bed early. Its called sleep hygiene. I have to take care of my spiritual and emotional well being too. It's a lot to do every day just to stay on top of things but it takes practice. Lots of practice. And keeping talking, talking, talking. Not arguing but processing and working things through. If you want to keep a marriage in any fit state you have to work hard at it. And I guess we do. Most of the time anyway.
Friday 28 June 2013
being a bi-polar parent
IT'S hard work actually. Parenting is really hard at the best of times. You are always juggling priorities, sacrificing, compromising and attempting to keep the peace. Crowd control is a daily ritual of mine. I have two gorgeous boys who are constantly at war over silly things like lego, pieces of bread or captain underpants outfits. It's all deadly serious. I find myself standing between them with a hand on each of their heads holding them apart! I have locked them in the house before and talked sense into them through an open window it's been that bad.
But my condition adds things in to the mix on top of the normal self doubt and fear a parent feels. Having crippling low self esteem makes me constantly critique myself and all of my decisions. If one of the children has a bad day I can assume they are depressed or showing signs of breakdown. I have a genuine fear that they will inherit my illness and struggle the way that I do and it's not something you want for your children. It's like you have a mood antenna on and every little ilk or ism they have you wonder if it's an expression of the lurking mental disease. It's quite terrifying. Your mind plays horrible tricks and I constantly have to reassure myself that it's only me that's ill and not them. Children have their own moods and childish ways and it's nothing to do with being insane. They are just bonkers like all other kids.
The other issue is when you have crippling depression finding the emotional energy to be available for your children. When they were really young I had to plan my days like a military operation with milestones throughout the day to get me through. You are exhausted anyway and trying to find that extra bit of energy to give it all you've got seems impossible. All you want to do is curl up and go to sleep and not bother. This is when the guilt and shame creeps in too as you are keenly aware that most mums actually enjoy having their children and relish fun afternoons and activities. You feel like you just want to give up. I remember turning up at a play group once and someone making a smart arse comment about breast feeding and thinking I'd cheerfully wring your neck, if you only know how hard my situation is you might shut your gob! Simple things become monstrous tasks and seem insurmountable. I remember spending a large amount of my time silently crying and hoping bed time would come soon. It's a sad reality that I didn't enjoy parenting for the first 3 years of my childrens life as I was so ill. But, even though I didn't want to do anything, I forced myself to do what they needed. I went to the bees bloody knees and played in the ball pit. I did painting and play doh, I cooked with them and played with them. Don't get me wrong - there were times when it felt an absolute joy and seeing them grow and develop was wonderful, but it wasn't consistent and it was a fight the whole way.
Parenting whilst hyper manic on the other hand is fine. Seriously. Boundless energy, humour, exciteabilty....whats not to love about it. You want to do everything and anything, but then you burn out and crash from the heights. Finding the middle ground is the only way forward, and knowing this gives me a reason to go on most of the time, and is a really important factor in my recovery. Normal parents struggle - I have to remember that and not give myself such a hard time. But that is hard especially when you set yourself a target of being a good parent despite the obstacles. Other people have problems not just me. It would be self obsessed to think I was the only one with a personal battle going on.
I have tried to talk to the children about being mentally ill and I explain it as having chemicals in my brain that don't work very well. I tell them that sometimes I just feel very sad and one day it will be better. They know I have to take tablets for it too. I remember them telling the mums at school that I couldn't drive as my brain chemicals had gone wrong! Bless them. They are so accepting and are so sweet in the morning when I feel all sedated, they come and drag me out of bed! They have had to come to appointments with me too at times and bound around the shrinks office causing chaos. I don't want them to be frightend of mental illness but I also want them to know you can get on with the business of living too when you are ill.
I know I fear my children having mental health problems in later life but I have to accept that I have very little power in that situation. All I can do is try my best and trust that the right messages get through and that they have my husbands mental genetics and not mine. And if they don't, then I'll have to deal with that as it comes along won't I.
But my condition adds things in to the mix on top of the normal self doubt and fear a parent feels. Having crippling low self esteem makes me constantly critique myself and all of my decisions. If one of the children has a bad day I can assume they are depressed or showing signs of breakdown. I have a genuine fear that they will inherit my illness and struggle the way that I do and it's not something you want for your children. It's like you have a mood antenna on and every little ilk or ism they have you wonder if it's an expression of the lurking mental disease. It's quite terrifying. Your mind plays horrible tricks and I constantly have to reassure myself that it's only me that's ill and not them. Children have their own moods and childish ways and it's nothing to do with being insane. They are just bonkers like all other kids.
The other issue is when you have crippling depression finding the emotional energy to be available for your children. When they were really young I had to plan my days like a military operation with milestones throughout the day to get me through. You are exhausted anyway and trying to find that extra bit of energy to give it all you've got seems impossible. All you want to do is curl up and go to sleep and not bother. This is when the guilt and shame creeps in too as you are keenly aware that most mums actually enjoy having their children and relish fun afternoons and activities. You feel like you just want to give up. I remember turning up at a play group once and someone making a smart arse comment about breast feeding and thinking I'd cheerfully wring your neck, if you only know how hard my situation is you might shut your gob! Simple things become monstrous tasks and seem insurmountable. I remember spending a large amount of my time silently crying and hoping bed time would come soon. It's a sad reality that I didn't enjoy parenting for the first 3 years of my childrens life as I was so ill. But, even though I didn't want to do anything, I forced myself to do what they needed. I went to the bees bloody knees and played in the ball pit. I did painting and play doh, I cooked with them and played with them. Don't get me wrong - there were times when it felt an absolute joy and seeing them grow and develop was wonderful, but it wasn't consistent and it was a fight the whole way.
Parenting whilst hyper manic on the other hand is fine. Seriously. Boundless energy, humour, exciteabilty....whats not to love about it. You want to do everything and anything, but then you burn out and crash from the heights. Finding the middle ground is the only way forward, and knowing this gives me a reason to go on most of the time, and is a really important factor in my recovery. Normal parents struggle - I have to remember that and not give myself such a hard time. But that is hard especially when you set yourself a target of being a good parent despite the obstacles. Other people have problems not just me. It would be self obsessed to think I was the only one with a personal battle going on.
I have tried to talk to the children about being mentally ill and I explain it as having chemicals in my brain that don't work very well. I tell them that sometimes I just feel very sad and one day it will be better. They know I have to take tablets for it too. I remember them telling the mums at school that I couldn't drive as my brain chemicals had gone wrong! Bless them. They are so accepting and are so sweet in the morning when I feel all sedated, they come and drag me out of bed! They have had to come to appointments with me too at times and bound around the shrinks office causing chaos. I don't want them to be frightend of mental illness but I also want them to know you can get on with the business of living too when you are ill.
I know I fear my children having mental health problems in later life but I have to accept that I have very little power in that situation. All I can do is try my best and trust that the right messages get through and that they have my husbands mental genetics and not mine. And if they don't, then I'll have to deal with that as it comes along won't I.
Friday 21 June 2013
Abilify and procyclidine
So I am on the munchies trail again, eating for 3 and trying to remain balanced. I never realised how tricky it would be trying to find a solution to the problem. I originally thought along the lines of months not years to get better when I first entered mental health services. The mind is truly a finely tuned organ that plays it's own song and doesn't take too kindly to a new conducter every 6 months.
The abilify did begin to lift my mood though. It stopped the dip but the horrid sluggishness was just painful. And to top it off it made me twitch. It also gave me a sense of butterflies in my tummy and heady anxiety known as Akathisia. It makes you feel like you can't sit still or get comfy and you pace around a lot feeling weird. So to stop this happening I was given procyclidine. Oh yes another medication in the mix. This one is an anti parkinsonian drug that stops my hands jiggling about and keeps the akathisia under control. Apparently you can't get it in America now, probably as it's not good for you I expect.
So I generally rattle as I walk along now. I take 2 tablets in the morning and 6 at night and function with a limited amount of joy at the pace of a snail. Slightly depressed snail - seems like the correct image. A little bit chubby, slightly sluggish, with a very vulnerable underbelly.
So the mood is lifting finally but I feel cross that I am now taking so much medication I can't see a future being without. It would take a mamoth effort to get off all of these tablets and be free and clear. I hate the need to be dependent on anything mood altering but I currently don't see another option. I have too much to lose by risking a complete withdrawal. I am stable, I am able to work, I function and do service at church, I am a wife and mother. Would I really want to give all of that up just to not take a handful of tablets? Probably not to be honest. But the thought still crosses my mind every night I stand by the sink with my glass of water ready to swallow. I wonder if I can get away with taking 1 or 2 less for a few days and see what happens. Apparently I am not on my own with these feelings at all. Many people will tell you that once they feel well they decide to stop taking their meds as they no longer need them, then sadly, end up in hospital after a nasty relapse. Maybe I'd be one of the lucky ones, who knows, but it is a game of russian routlette. But I really need to talk about what it's like being a mental health wife really don't I, I suppose....
The abilify did begin to lift my mood though. It stopped the dip but the horrid sluggishness was just painful. And to top it off it made me twitch. It also gave me a sense of butterflies in my tummy and heady anxiety known as Akathisia. It makes you feel like you can't sit still or get comfy and you pace around a lot feeling weird. So to stop this happening I was given procyclidine. Oh yes another medication in the mix. This one is an anti parkinsonian drug that stops my hands jiggling about and keeps the akathisia under control. Apparently you can't get it in America now, probably as it's not good for you I expect.
So I generally rattle as I walk along now. I take 2 tablets in the morning and 6 at night and function with a limited amount of joy at the pace of a snail. Slightly depressed snail - seems like the correct image. A little bit chubby, slightly sluggish, with a very vulnerable underbelly.
So the mood is lifting finally but I feel cross that I am now taking so much medication I can't see a future being without. It would take a mamoth effort to get off all of these tablets and be free and clear. I hate the need to be dependent on anything mood altering but I currently don't see another option. I have too much to lose by risking a complete withdrawal. I am stable, I am able to work, I function and do service at church, I am a wife and mother. Would I really want to give all of that up just to not take a handful of tablets? Probably not to be honest. But the thought still crosses my mind every night I stand by the sink with my glass of water ready to swallow. I wonder if I can get away with taking 1 or 2 less for a few days and see what happens. Apparently I am not on my own with these feelings at all. Many people will tell you that once they feel well they decide to stop taking their meds as they no longer need them, then sadly, end up in hospital after a nasty relapse. Maybe I'd be one of the lucky ones, who knows, but it is a game of russian routlette. But I really need to talk about what it's like being a mental health wife really don't I, I suppose....
Thursday 20 June 2013
A typical anti psychotics - a guide to
Definition: The atypical antipsychotics (AAP) (also known as second generation antipsychotics) are a group of antipsychotic tranquilizing drugs used to treat psychiatric conditions. Some atypical antipsychotics are FDA approved for use in the treatment of schizophrenia. Some carry FDA approved indications for acute mania, bipolar depression, psychotic agitation, bipolar maintenance, and other indications. Both generations of medication tend to block receptors in the brain's dopamine pathways, but atypicals at the time of marketing were claimed to differ from typical antipsychotics in that they are less likely to cause extrapyramidal motor control disabilities in patients, which include unsteady Parkinson's disease-type movements, body rigidity and involuntary tremors. Oh Good.
So the side effeects are:
Headaches -- in up to 27 percent of people
A sedated feeling -- up to 23 percent
Agitation -- up to 19 percent
Insomnia -- up to 18 percent (see Abilify and Insomnia)
Fatigue -- up to 17 percent
Anxiety -- up to 17 percent
Drowsiness -- up to 16 percent
Nausea -- up to 15 percent
Vomiting -- up to 14 percent
Restlessness -- up to 12 percent
Constipation -- up to 11 percent.
Some other common side effects (occurring in 2 percent to 10 percent of people) included:
Dizziness
Indigestion or heartburn
Shakiness (tremors)
Weight gain (see Abilify and Weight Gain)
Restlessness
Fatigue
Dry mouth (see Abilify and Dry Mouth)
Joint pain
Throat pain
Blurred vision
Abdominal pain (stomach pain)
Pain
Cough
Nasal congestion
Increased salivation
Swelling or water retention in the arms, legs, or feet.
Bless my psychiatrist and his ways. This is his new idea to ensure my sanity and stability. He tells me that as well as ensuring a non hyper manic state the abilify should increase my mood to stop the dip that I am experiencing. After the quetiapine experience I am very reluctant to play ball but he promises me this will be a better experience and gives me 20 mg to set me off. I am also told that as the patent hasn't run out on this medication and is costs approx. £200 a pop for 28 days supply. Now I am an emotional burden as well as a financial one. Fabulous. So off I trolley with my prescription and try not to be worried about the extensive list of side effects. What a nightmare. Sometimes I wonder whether or not to risk just coming off of everything and trying to go it alone. I am sure everyone would completely freak out if I did this but sometimes I fantasize about a medication free life. I am sure at some time in my life I was well and didn't need a host of medicines to determine my every mood but it is a distant memory. Thinking the possibilty through of being medication free though makes me think about what I did use in order to stop feeling high or low before my diagnosis. I think everyone tries to manage their mood in some way by using a stimulus whether or not it's a film, a drink, a cuddle, a prayer. I didn't realise how much your mood can shift during a day until I kept a mood diary. It's exhausting. I did a CBT course on self esteem. Have I told you that already? I had to monitor my mood every hour I was awake for a week and explain what was going on and how I felt. When the week was over I was emotionally crucified. There's nothing like a bit of mood diarying to help you feel crap about yourself. Talk about down on yourself. I have the lowest opinion of myself going - you don't need to tell me how bad I am, I am a practised and qualified person at doing that all by myself thank you very much. My bottom line is a deeply entrenched one I can tell you.
So yes, my mood is dipped and I am struggling a little with self esteem.OK so I have no self esteem, and this is compounded by work stress, parenting and being a wife. More on this another day. So I take the damn abilify and will ride out the consequences. And the consequences begin quite soon. Sedation, my old friend, returns with avengence. I have to peel myself off the bed in the morning and hold my eyes open for an hour and force caffeine down my throat just to begin functioning. Don't let me close them again as I will sleep for a few hours without warning. I have to drive to work with music blaring and window open to keep focussed. I have a dry mouth permanently and want to EAT. EAT, EAT and EAT! Oh my goodness. Craving for food that cannot be diminished by any amount of food. After eating, give it half and hour and I feel like eating another meal again. It's an insatiable hunger that doesn't disappear. I want to gorge on MacDonalds beakfasts and cakes and all the bad things in the world. I keep wanting to buy family packs of whispers again. The quetiapine feeling is on the return and I have to trust that it will ease up at some point. If I carry on I am going to be the size of a house. I have to weigh up whether or not to carry on with these new tablets or give up on them altogether and be stuck in the depressive rut. It's not a great choice to make, but I need to decide, and decide soon.
So the side effeects are:
Headaches -- in up to 27 percent of people
A sedated feeling -- up to 23 percent
Agitation -- up to 19 percent
Insomnia -- up to 18 percent (see Abilify and Insomnia)
Fatigue -- up to 17 percent
Anxiety -- up to 17 percent
Drowsiness -- up to 16 percent
Nausea -- up to 15 percent
Vomiting -- up to 14 percent
Restlessness -- up to 12 percent
Constipation -- up to 11 percent.
Some other common side effects (occurring in 2 percent to 10 percent of people) included:
Dizziness
Indigestion or heartburn
Shakiness (tremors)
Weight gain (see Abilify and Weight Gain)
Restlessness
Fatigue
Dry mouth (see Abilify and Dry Mouth)
Joint pain
Throat pain
Blurred vision
Abdominal pain (stomach pain)
Pain
Cough
Nasal congestion
Increased salivation
Swelling or water retention in the arms, legs, or feet.
Bless my psychiatrist and his ways. This is his new idea to ensure my sanity and stability. He tells me that as well as ensuring a non hyper manic state the abilify should increase my mood to stop the dip that I am experiencing. After the quetiapine experience I am very reluctant to play ball but he promises me this will be a better experience and gives me 20 mg to set me off. I am also told that as the patent hasn't run out on this medication and is costs approx. £200 a pop for 28 days supply. Now I am an emotional burden as well as a financial one. Fabulous. So off I trolley with my prescription and try not to be worried about the extensive list of side effects. What a nightmare. Sometimes I wonder whether or not to risk just coming off of everything and trying to go it alone. I am sure everyone would completely freak out if I did this but sometimes I fantasize about a medication free life. I am sure at some time in my life I was well and didn't need a host of medicines to determine my every mood but it is a distant memory. Thinking the possibilty through of being medication free though makes me think about what I did use in order to stop feeling high or low before my diagnosis. I think everyone tries to manage their mood in some way by using a stimulus whether or not it's a film, a drink, a cuddle, a prayer. I didn't realise how much your mood can shift during a day until I kept a mood diary. It's exhausting. I did a CBT course on self esteem. Have I told you that already? I had to monitor my mood every hour I was awake for a week and explain what was going on and how I felt. When the week was over I was emotionally crucified. There's nothing like a bit of mood diarying to help you feel crap about yourself. Talk about down on yourself. I have the lowest opinion of myself going - you don't need to tell me how bad I am, I am a practised and qualified person at doing that all by myself thank you very much. My bottom line is a deeply entrenched one I can tell you.
So yes, my mood is dipped and I am struggling a little with self esteem.OK so I have no self esteem, and this is compounded by work stress, parenting and being a wife. More on this another day. So I take the damn abilify and will ride out the consequences. And the consequences begin quite soon. Sedation, my old friend, returns with avengence. I have to peel myself off the bed in the morning and hold my eyes open for an hour and force caffeine down my throat just to begin functioning. Don't let me close them again as I will sleep for a few hours without warning. I have to drive to work with music blaring and window open to keep focussed. I have a dry mouth permanently and want to EAT. EAT, EAT and EAT! Oh my goodness. Craving for food that cannot be diminished by any amount of food. After eating, give it half and hour and I feel like eating another meal again. It's an insatiable hunger that doesn't disappear. I want to gorge on MacDonalds beakfasts and cakes and all the bad things in the world. I keep wanting to buy family packs of whispers again. The quetiapine feeling is on the return and I have to trust that it will ease up at some point. If I carry on I am going to be the size of a house. I have to weigh up whether or not to carry on with these new tablets or give up on them altogether and be stuck in the depressive rut. It's not a great choice to make, but I need to decide, and decide soon.
Wednesday 19 June 2013
Work and WRAP
Well I got through Christmas and decided to return to work. I was allowed to drive again and had been feeling quite well really so it felt like the appropriate time. The 8th January will be forever emblazoned on my memory. At the time the date was of no significance. I eased back in to the office hum drum on a gentle phased return and thought that all was well. Then on returning to my allotted hours I was called in to a meeting with my manager and the human resources woman (I want to write the word cow/jobs worth/nasty words...all the nasty words I can think of) . I clearly remember the patronising face she pulled as she feigned concern whilst delivering me a written warning for sickness. OK. So I have a disability which I thought gave me a degree of protection against this type of procedure. I was sadly misinformed. I even called the equality commission and it turns out that they cannot give me special treatment really as I am only one person doing a single job and operationally they had been compromised too much so a warning fell within the normal remit of sickness. I know it sounds wrong but they toed the line. They'd let me have impairment related sick days, let me work from home and been supportive in the past.
Now how this works is that you cannot have more than 3 incidents of sickness in 3 months or 10 days in a block together as then you'll get pulled back in to another meeting for a chat. If that were to happen I would be given a final warning, and then if it happened again I would be fired pretty much. My lovely warning ran from the 8th January 2012 for an entire year. Considering at this point that I hadn't managed more then 10 months being well it felt like a mountain to climb. I couldn't envisage being well for that long without a relapse considering the stress they had just put me under. Essentially the warning would stay on my file for a year but the trigger system would then run again for the following year anyway, so for me to be warning free I'd have to manage about 2 years without a mental health relapse or any type of illness. Yeah right. The general response from everyone around me was one of disgust. I know employers don't want a lame duck on their team but lame ducks try hard to float and turn up most of the time when they are well.
So I showed up. I tried to do my best and tried my hardest not to be ill. Not just mentally ill but physically ill, not such an easy thing to do when you have small children full of germs. And then my mood started to dip. It was only a gradual dip, but it was definitely a dip. This is when the WRAP comes in useful. The Wellness Recovery Action Plan. It's a little booklet the mental health team give you that helps you to identify when things are going a bit awry and off beam. You have to write down what you are like when you are well, not so well, ill and under a bus. You are then meant to read through it and figure out where you are at and what intervention you might need. It is actually very useful to do as when you are becoming ill, a level of denial can creep in or the attitude of "It's not that bad really" can hang about. It gives you a fact based criteria to measure yourself against and gives you a clear direction about what to do next.
So I was at the not so well part of the plan. Needing some help but not a staged and intensive intervention. The intrusive thoughts were creeping in, the emotional fatigue, irritability, tearfulness and a general feeling of sadness. Back to the psychiatrist I went and shared with him my concerns and guess what? May I introduce you to abilify.
Now how this works is that you cannot have more than 3 incidents of sickness in 3 months or 10 days in a block together as then you'll get pulled back in to another meeting for a chat. If that were to happen I would be given a final warning, and then if it happened again I would be fired pretty much. My lovely warning ran from the 8th January 2012 for an entire year. Considering at this point that I hadn't managed more then 10 months being well it felt like a mountain to climb. I couldn't envisage being well for that long without a relapse considering the stress they had just put me under. Essentially the warning would stay on my file for a year but the trigger system would then run again for the following year anyway, so for me to be warning free I'd have to manage about 2 years without a mental health relapse or any type of illness. Yeah right. The general response from everyone around me was one of disgust. I know employers don't want a lame duck on their team but lame ducks try hard to float and turn up most of the time when they are well.
So I showed up. I tried to do my best and tried my hardest not to be ill. Not just mentally ill but physically ill, not such an easy thing to do when you have small children full of germs. And then my mood started to dip. It was only a gradual dip, but it was definitely a dip. This is when the WRAP comes in useful. The Wellness Recovery Action Plan. It's a little booklet the mental health team give you that helps you to identify when things are going a bit awry and off beam. You have to write down what you are like when you are well, not so well, ill and under a bus. You are then meant to read through it and figure out where you are at and what intervention you might need. It is actually very useful to do as when you are becoming ill, a level of denial can creep in or the attitude of "It's not that bad really" can hang about. It gives you a fact based criteria to measure yourself against and gives you a clear direction about what to do next.
So I was at the not so well part of the plan. Needing some help but not a staged and intensive intervention. The intrusive thoughts were creeping in, the emotional fatigue, irritability, tearfulness and a general feeling of sadness. Back to the psychiatrist I went and shared with him my concerns and guess what? May I introduce you to abilify.
Saturday 15 June 2013
The depakote years part two
Ok so I've been climbing up the slippery pole, bonded with the crisis team, been banned from driving for six months and generally been feeling pretty rough at this point. But miracle of miracles, 3 months down the line I start to feel reasonably ok. It's an odd sensation coming out of the Deep, dark wood. The mist began to lift. I could string a sentence together and spell words again. My ability to converse with people and maintain eye contact was much improved. Everything tired me out but hey, I was functioning again. The depression end of my condition is savage. It is rapacious and destructive. Once it begins to abate even slightly, you feel the grip of it around your throat begin to ease and you can literally start to breathe again. Holding on through that phase is all you can do. The mania is rampant, unforgiving and makes you terribly vulnerable to complete breakdown. Even though the mania begins with the fluttery stomach butterflies and a sense of well being and exhilaration, it becomes your worst enemy. Thankfully in my case, it doesn't last longer than three to four days. Depression can last for months and months. I was glad it had started to release me from it's grip so soon.
It's worth mentioning here that I had started to go to Church again after many years on sabbatical. My choice as I had found it hard to engage with Christians. I know - Church is full of them right. But actually Christians are a microcosm of the normal world so it still has quite a lot of nasty people knocking about and I had had my fair share of abuse and judgement. Anyway, these Christians knew that I had this condition and when I had my relapse they were the most amazing bunch of people around. They prayed for me constantly, made up a rota to ensure that someone came to see me every day and generally carried me when I couldn't carry myself. Sometimes they took me to psychiatric appointment, sometimes they played with the kids but most of all they showed me love and acceptance. I love those guys. I felt safe with them and they are precious people in my life.
So at the three month point I am slightly less mad, a little skittish but managing ok. Then I get a call from my GP. A GP calling me at home. At first I thought someone had died and they had been nominated to tell me as I was so fragile. Turns out no one had died at all. The anti depressant I was taking had been deemed to be dangerous for the heart and I would need to cut it down drastically without much notice or stop taking it all together. Brilliant. Just coming out of a major relapse and now having to toy with medication. The risks of me reducing the citalopram and becoming ill again were quite high. Basically when I got to see the GP I was told that the rhythm of the heart beat could be drastically affected and that permanent damage could occur if I continued to take the maximum dose. We decided together to drop from 60mg to 40mg and to stay off work for another 6 to 8 weeks to ensure my survival! It's bad enough taking medication that can make you fat, make you have twitching arms and legs, make you have a dry mouth, mess with your liver function.... I could go on. Having a permanent heart problem was not on my list of must haves. I had to have a heart trace done to make sure I was ok. Who would have thought that medication that is meant to be making you feel well can do such horrible things to you physically. I remember asking my shrink how long it would be before I could be medication free. His response was not a welcome one I can assure you. "If you stay stable for between 2 and 5 years I will consider it." Two to five years!!! That is ages.
It's worth mentioning here that I had started to go to Church again after many years on sabbatical. My choice as I had found it hard to engage with Christians. I know - Church is full of them right. But actually Christians are a microcosm of the normal world so it still has quite a lot of nasty people knocking about and I had had my fair share of abuse and judgement. Anyway, these Christians knew that I had this condition and when I had my relapse they were the most amazing bunch of people around. They prayed for me constantly, made up a rota to ensure that someone came to see me every day and generally carried me when I couldn't carry myself. Sometimes they took me to psychiatric appointment, sometimes they played with the kids but most of all they showed me love and acceptance. I love those guys. I felt safe with them and they are precious people in my life.
So at the three month point I am slightly less mad, a little skittish but managing ok. Then I get a call from my GP. A GP calling me at home. At first I thought someone had died and they had been nominated to tell me as I was so fragile. Turns out no one had died at all. The anti depressant I was taking had been deemed to be dangerous for the heart and I would need to cut it down drastically without much notice or stop taking it all together. Brilliant. Just coming out of a major relapse and now having to toy with medication. The risks of me reducing the citalopram and becoming ill again were quite high. Basically when I got to see the GP I was told that the rhythm of the heart beat could be drastically affected and that permanent damage could occur if I continued to take the maximum dose. We decided together to drop from 60mg to 40mg and to stay off work for another 6 to 8 weeks to ensure my survival! It's bad enough taking medication that can make you fat, make you have twitching arms and legs, make you have a dry mouth, mess with your liver function.... I could go on. Having a permanent heart problem was not on my list of must haves. I had to have a heart trace done to make sure I was ok. Who would have thought that medication that is meant to be making you feel well can do such horrible things to you physically. I remember asking my shrink how long it would be before I could be medication free. His response was not a welcome one I can assure you. "If you stay stable for between 2 and 5 years I will consider it." Two to five years!!! That is ages.
Friday 14 June 2013
The depakote years part one
Ok so I haven't blogged in a very long time. For some reason, I don't know why, I haven't felt inclined to write. Its been two and a half years in the depakote world. But not only that it's also been the abilify years, the "reduce the hours at work and get threatend with a awarning for sickness" years, the children starting school years as well as working, being a wife, losing weight then getting fat again and going back to church years.....Maybe I just started really living again. Oh yes and I had a major relapse and had the crisis team out and thought I might end up in hospital. Great. It's been a bit of a roller coaster.
Depakote worked quite well for me for a time. As well as being an anti-epileptic it acts as a mood stabaliser.Now free of the quetiapine I stopped being fat and being mad. Fat and mad is unatractive and difficult to live with.It stifled my self esteem and confidence massively. One or the other I can cope with but together it's soul destroying. Amazingly within a week or two of taking the depakote I felt really well. The sedation stopped, the weight I had gained on the quetiapine started to fall off as did my appetite, and the battle in my mind seemed to be calmed. I felt alive again. Things felt ok and I began to believe that maybe they had got the medication right after a very long time. It is so freeing to be able to wake up in the morning refreshed and energetic instead of slugish and sedated. I felt really positive for the first time in a long time. I started to use the gym regularly and also joined weight watchers. If you'd have asked me a few years back what I would be doing in my life, weight watchers would not be on the radar. But hey, it was llike a coffee morning with some older ladies. And I enjoyed it. Depression sucks the enjoyment out of everything. Life is grey and meaningless. It is joyless and bleak. Being catapulted back to normality is amazing but terrifying too. There is always an underlying fear of relapse and sense of "This is to be good to be true" hanging about. Practising being happy and trusting the medication and CBT takes time. Things felt like they were going to be ok.
So I am getting thin and enjoying life; things seems to be going well or so I thought. Then in the July after ten months of wellness BAM. Out of nowhere things start speeding up at a rate of knots. In hind sight, I was probably quite stressed and tired but didn't recognise this early enough. I couldn't sleep on Tuesday night and then on Wednesday morning I started to feel incredibly rushy. My breathing was fast, my heart rate was banging and I felt light headed and exciteable. The space in my head felt like it was mushrooming and becoming too enlarged to be held by my skull. At this point my hope was that I'd drunk too much coffee but it was too intense and almost a tidal wave of speed overwhelming me. It's a weird sensation almost like an out of body experience or floating along on a hovercraft. It's deeply unsettling and you feel completely powerless, and that includes my mouth running away from itself. And this is where the embarrassing behaviour begins. Running up and down the office to get involved in a leaving gathering. Jumping into other peoples photos being taken. Smiling maniacally at people and swearing at the top of my voice in teh office. Lack of boundaries and getting into peoples private space. Standing with a colleague in the street telling them I can write pornography for a book if they like. Striving to not spend £400 on clothes in my lunch break even though I had the cash in my pocket. Scary stuff for me and this is the begining of the ride. And so it continued. Explosive thoughts and speed of body. Agitation and fear and Panic. Paranoia that people can see you being mentally ill and giving you sideways glances as you appear different to your normal self. It's at this point I decide to call my CPN and explain what was going on. Reading back on this experience I left this call far to late in the day. The mania was already underway and out of control. I ran to a spare office in the building where I worked, curled up in a ball and called the lovely Fran. Sadly she couldn't understand a word I was saying as I was speaking at such a rate it was gibberish. She shouted slightly for me to shut up which worked a treat and asked me if I was feeling safe enough to manage over the weekend. The bottom line is that "if you can't, you need to get the extra help in and it needs to be now" she says. I agree to try and manage over the weekend as I thankfully had an appointment with the cpn on the following Tuesday. If I need extra help over the weekend, I either need to call the out of hours GP or go to A+E. Oh joy! I clearly remember leaving work, and when trying to cross the road heard a voice telling me to throw myself under a bus. I asked the woman next to me if she had heard the statement as I though it was the guy in front of me. She looked at me with some concern. Great. Hearing voices too, just to make my day even more special. I remember thinking that as long as I can get home, I'll be ok. If I can sleep, maybe it'll stop. I'm just going to have to trust that the mania will run it's course and be quick to finish. I cannot cope with the intensity for much longer. Hypermania only lasts a few days - full blown mania can last a week.
Friday. Oh my. What goes up, must come down. Sick, I felt so sick. Mentally sick and totally drained of energy. When your mind has been on fast forward for two and a half days, you feel like someone has put a bullet through your head and there is a wide and empty space of blackness. You are also physically exhausted. I dragged myself to work and spent most of the day staring into space or with my head on the desk. Everone knew I was ill it was obvious.I got home and slept like the dead. I wandered around most of the weekend like a lost sheep with a sense of complete detachment from myself. Stuck in Sylvia Plaths Bell Jar, I bounced around in what is fondly named a mixed phase episode for a week. Up and down and up and really down and then off the cliff into despair. This is all happening during the summer holidays too so I am trying to stay on an even keel for the children and its starting to become really tricky to say the least. I remember taking the kids to their aunts to meet granny on theTuesday. I needed to drop them off for childcare so that I could go to work and thinking I could leave them in safe care, and go and drive my car in the canal on the way home. When I gave them a cuddle goodbye I honestly thought I was saying goodbye for ever. It felt so catastrophic but ultimately there would be a sense of relief to stop the dreadful feelings I was having.
This is when the psychiatrist got involved. I sat on the little chair next to the desk where he pops the tissues and basically fell to pieces. I had definately hit the bottom. A mixed phase episode carries a high risk of suicide so he took me really seriously when I said I had thought about dying as a way of release. So now we welcome in The Crisis team. Welcome to the A team of mental health. If you have a problem, and you can find them, maybe you can hire them! Praise be for the lovely people who came to visit me at my house. I was banned from driving (Obviously) and they doubled my medication and tried to give me diazepam which I flatly refused. For six weeks they came and saw me every other day, and the only reason they kept me out of hospital is that I wanted to ensure that I could find the will to stay alive for my children, and being around them at home would be better than placing me on a ward. It was a tough six weeks crawling my way back up the dark and slippery pole but it was worth it. They didn't judge me, they listened with love and they encouraged me to keep going even when I though I might just give up. I think I have said it before that dying feels like a valid option as then your family can just get on with the business of living without the worry of you and your depression. I had to fight those feelings and try to believe that being alive was the valid option. Trying to use all of the strategies I had been taught and digging deep was the only way out of the situation and it really was the better option. I had to keep the faith that things were worth fighting for.
Depakote worked quite well for me for a time. As well as being an anti-epileptic it acts as a mood stabaliser.Now free of the quetiapine I stopped being fat and being mad. Fat and mad is unatractive and difficult to live with.It stifled my self esteem and confidence massively. One or the other I can cope with but together it's soul destroying. Amazingly within a week or two of taking the depakote I felt really well. The sedation stopped, the weight I had gained on the quetiapine started to fall off as did my appetite, and the battle in my mind seemed to be calmed. I felt alive again. Things felt ok and I began to believe that maybe they had got the medication right after a very long time. It is so freeing to be able to wake up in the morning refreshed and energetic instead of slugish and sedated. I felt really positive for the first time in a long time. I started to use the gym regularly and also joined weight watchers. If you'd have asked me a few years back what I would be doing in my life, weight watchers would not be on the radar. But hey, it was llike a coffee morning with some older ladies. And I enjoyed it. Depression sucks the enjoyment out of everything. Life is grey and meaningless. It is joyless and bleak. Being catapulted back to normality is amazing but terrifying too. There is always an underlying fear of relapse and sense of "This is to be good to be true" hanging about. Practising being happy and trusting the medication and CBT takes time. Things felt like they were going to be ok.
So I am getting thin and enjoying life; things seems to be going well or so I thought. Then in the July after ten months of wellness BAM. Out of nowhere things start speeding up at a rate of knots. In hind sight, I was probably quite stressed and tired but didn't recognise this early enough. I couldn't sleep on Tuesday night and then on Wednesday morning I started to feel incredibly rushy. My breathing was fast, my heart rate was banging and I felt light headed and exciteable. The space in my head felt like it was mushrooming and becoming too enlarged to be held by my skull. At this point my hope was that I'd drunk too much coffee but it was too intense and almost a tidal wave of speed overwhelming me. It's a weird sensation almost like an out of body experience or floating along on a hovercraft. It's deeply unsettling and you feel completely powerless, and that includes my mouth running away from itself. And this is where the embarrassing behaviour begins. Running up and down the office to get involved in a leaving gathering. Jumping into other peoples photos being taken. Smiling maniacally at people and swearing at the top of my voice in teh office. Lack of boundaries and getting into peoples private space. Standing with a colleague in the street telling them I can write pornography for a book if they like. Striving to not spend £400 on clothes in my lunch break even though I had the cash in my pocket. Scary stuff for me and this is the begining of the ride. And so it continued. Explosive thoughts and speed of body. Agitation and fear and Panic. Paranoia that people can see you being mentally ill and giving you sideways glances as you appear different to your normal self. It's at this point I decide to call my CPN and explain what was going on. Reading back on this experience I left this call far to late in the day. The mania was already underway and out of control. I ran to a spare office in the building where I worked, curled up in a ball and called the lovely Fran. Sadly she couldn't understand a word I was saying as I was speaking at such a rate it was gibberish. She shouted slightly for me to shut up which worked a treat and asked me if I was feeling safe enough to manage over the weekend. The bottom line is that "if you can't, you need to get the extra help in and it needs to be now" she says. I agree to try and manage over the weekend as I thankfully had an appointment with the cpn on the following Tuesday. If I need extra help over the weekend, I either need to call the out of hours GP or go to A+E. Oh joy! I clearly remember leaving work, and when trying to cross the road heard a voice telling me to throw myself under a bus. I asked the woman next to me if she had heard the statement as I though it was the guy in front of me. She looked at me with some concern. Great. Hearing voices too, just to make my day even more special. I remember thinking that as long as I can get home, I'll be ok. If I can sleep, maybe it'll stop. I'm just going to have to trust that the mania will run it's course and be quick to finish. I cannot cope with the intensity for much longer. Hypermania only lasts a few days - full blown mania can last a week.
Friday. Oh my. What goes up, must come down. Sick, I felt so sick. Mentally sick and totally drained of energy. When your mind has been on fast forward for two and a half days, you feel like someone has put a bullet through your head and there is a wide and empty space of blackness. You are also physically exhausted. I dragged myself to work and spent most of the day staring into space or with my head on the desk. Everone knew I was ill it was obvious.I got home and slept like the dead. I wandered around most of the weekend like a lost sheep with a sense of complete detachment from myself. Stuck in Sylvia Plaths Bell Jar, I bounced around in what is fondly named a mixed phase episode for a week. Up and down and up and really down and then off the cliff into despair. This is all happening during the summer holidays too so I am trying to stay on an even keel for the children and its starting to become really tricky to say the least. I remember taking the kids to their aunts to meet granny on theTuesday. I needed to drop them off for childcare so that I could go to work and thinking I could leave them in safe care, and go and drive my car in the canal on the way home. When I gave them a cuddle goodbye I honestly thought I was saying goodbye for ever. It felt so catastrophic but ultimately there would be a sense of relief to stop the dreadful feelings I was having.
This is when the psychiatrist got involved. I sat on the little chair next to the desk where he pops the tissues and basically fell to pieces. I had definately hit the bottom. A mixed phase episode carries a high risk of suicide so he took me really seriously when I said I had thought about dying as a way of release. So now we welcome in The Crisis team. Welcome to the A team of mental health. If you have a problem, and you can find them, maybe you can hire them! Praise be for the lovely people who came to visit me at my house. I was banned from driving (Obviously) and they doubled my medication and tried to give me diazepam which I flatly refused. For six weeks they came and saw me every other day, and the only reason they kept me out of hospital is that I wanted to ensure that I could find the will to stay alive for my children, and being around them at home would be better than placing me on a ward. It was a tough six weeks crawling my way back up the dark and slippery pole but it was worth it. They didn't judge me, they listened with love and they encouraged me to keep going even when I though I might just give up. I think I have said it before that dying feels like a valid option as then your family can just get on with the business of living without the worry of you and your depression. I had to fight those feelings and try to believe that being alive was the valid option. Trying to use all of the strategies I had been taught and digging deep was the only way out of the situation and it really was the better option. I had to keep the faith that things were worth fighting for.
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