Mixed Episode: What Happens When Dr Jekyll Meets Mr Hyde

I am now back to posting on this blog. I have realised that I need it as an outlet for my own thoughts and it is cathartic to type these down somewhere even if it is only on a blog, and in a place where I have a record of my thoughts, moods and actions.

I have been stuck in a mixed episode for the last couple of weeks. I have never fully encountered a full blown mixed episode before. Sure, I’ve had the odd manic day where I feel a bit miserable or a depressed day when I feel anxious but nothing like the hell hole I am enduring where the two come clashing together.

It started with not being able to sit still and yet my body feeling absolutely knackered and depressed as hell. Then I couldn’t concentrate on anything, no matter how inane. Then my thoughts started racing at 300mph and the lights and noises in the flat got too bright and loud to cope with. Then I got headaches from thinking about too many things too quickly, and then came the awful, awful hallucinations. Seeing things that weren’t there, feeling like ants were crawling under my skin, scratching away at myself to let them out.

I saw my GP and she prescribed me diazepam to take until I saw Dr Mc, who prescribed me a mid-weight dose of haloperidol and asked to see me again in a week. The haloperidol got rid of the hallucinations but my head was still running so he has halved the venlafaxine to see if that makes any difference. Finally my lithium levels are at 0.7 which is respectable and my veins are returning to normal after the mass of blood tests to check the levels.

I am now solely in the care of the NHS after discharging myself from Dr Mc, Jane and the Priory. I couldn’t face being under the financial control of my Dad any longer. I am meeting a new CPN from SW London on Wednesday as my last care co-ordinator and I didn’t particularly gel, and will then wait to see the team psychiatrist and I imagine get put on the very long waiting list for therapy. It will be interesting to see how they work. Dr Mc and Jane have both written letters saying they are concerned about me (I promised I wouldn’t do anything over Christmas or New Year and now Dr Mc seems convinced that the self-harm/suicide risk will increase after the New Year period) and the GP has also faxed some information across.

In the meantime I am waiting for the excess venlafaxine to exit my system and for my head to calm down, or my body to wake up to the speed of my head. One or the other, but not the disjointed chaos I am in at the moment.

Ruth x

A Handbag?: What I Carry Around & An Insight Into My Life

Before I start, I would just like to wish everyone who reads this blog a very happy new year and I hope that 2010 is peaceful and prosperous.

This post I have decided is a photo post showing you my favourite handbag and it’s contents.

There is a tin of Burt’s Bees mints that my brother brought me back from America in the handle. Also in the handle is my inhaler. Clockwise from the bottom is my Burt’s Bees lipbalm (I am obsessed with Burt’s Bees stuff), my phone (Samsung F490 although I will get a new shiny Blackberry next week), my tablet tin which contains one 5mg diazepam, one 2mg lorazepam and one 5mg haloperidol, a pair of gloves, a box of Twinings cranberry and pomegranate fruit teabags, a stressball stolen (ahem, I mean acquired) from the Priory, my iPod (120gb Classic), my umbrella, my purse (also from Ness which is where the bag is from and bought by my sister in Edinburgh) and finally my diary.

Thought that might tell you all a little more about me.

Ruth x

Stuck In A Grey Haze: I Am A Bad Blogger So Shoot Me Now

I have neglected this blog for far too long, however, people who are around me on a regular basis would say that I have been neglecting a lot of things recently. Friendships have been a main one for me, I seem to have turned myself into a recluse but some very good friends are trying, somewhat unsuccessfully, to rectify this. With neglecting my friends comes hiding myself away from all forms of social contact and that includes this blog.

To be honest I’m not sure how much longer I can keep this blog going. My life seems a monotony of medication, appointments, misery punctuated with the odd hypomania, attendances at A&E and subsequent assessments by the psych liaison nurses/duty psychs. It does not make for interesting reading.

I am approaching some bad anniversaries in my life. The last 12 months have been horrendous and I am not sure what has changed over the course of the year. I need to focus on keeping me safe and getting through until the New Year. That may include writing this blog, but it may not. I am not sure at present.

Either way I will let you, the readers, know of my decision.

Ruth

End Of An Era: Moving Into A New Part Of My Life

I am formally changing my address on Monday. As of Monday I will no longer reside in the Royal Borough of Kensington and Chelsea. I will no longer live in the house that was my childhood home. Live in the bedroom that still freaks me out because of events that have happened there. Not have to look at my carpet and try and remember where each stain came from. The stain that was from me throwing up on cheap schnapps at a friend’s 16th. The stains from cutting my arms/legs/any other part of my body a bit too deeply. The stain outside my door from where my Dad assaulted my Mum. Be able to look out of the window at the view that I have escaped into for many years. Apart from 5 years at uni I have lived in this house all my life. Apart from 4 and a half years in Newcastle and 6 months in Bloomsbury I have always lived in this part of London. I have always been a South Kensington girl, but only for one last weekend.

On Monday I move into my boyfriend’s flat in Battersea, in the rather less posh sounding (but very up and coming) Borough of Wandsworth. I am scared of moving in with someone. I am notoriously bad to live with and I know that although he is accepting of my faults and weird habits, living with someone day-in, day-out may prove to be a step too far. I already have a back up plan in the form of my friend who has offered her spare room out if it gets too much, but that is negativity. It will work. Why should it not work? I will be living in a lovely flat near Battersea Park where I can go for long walks and enjoy my surroundings. I am living with someone who cares about me and wants to protect me from all the evils that have been thrown at me at home. I am taking my lovely, lovely cat with me. I am worried about leaving my Mum to survive but I am 24, I have to move out of home and stop being responsible for her.

I had my last appointment with Allison today. From Monday my care will be transferred to South West London and St Georges’ Mental Health Trust. Allison has been sending the referral faxes off for the last week or so and has asked the Crisis Team to ring me on Monday when all my address changes have gone through, if only to make contact and to try and update me on a timescale for an appointment.I already have pre-registered with a GP practice so that is one hassle out of the way.

I will sort of miss Allison. I have been seeing her for a year and a lot of things have changed in that 12 months. When she first met me I had been an inpatient, firstly in Newcastle and then transferred to South Ken & Chelsea. I had been shifted onto her caseload from the Assertive Outreach Team who thought I was too nice and compliant to be involved with them. The first time I met her she frogmarched me to Minor Injuries to get some cuts looked at and explained it all to the woman on reception as I was incapable of talking, she even rang me later that day to check I was OK. She saw me in an emergency after I ended up in A&E near my brother’s, she saw me after 2 suicide attempts and even admitted she thought she’d lost me after she got news of the first one, she came and visited me in the Priory after the 3rd attempt in 4 weeks and brought me trashy magazines that she had finished reading. She has supported me through operations due to my self-harm, operations due to the cancer, chemotherapy, the start of radiotherapy, she has talked with me when I have been up most of the night supporting my Mum. She has seen me start a job in recent weeks back at my old school and hopefully find my feet in a world where I am certain (as it is my old stamping ground) but probably too eager to please (as members of staff are still there).

This has probably been one of the most turbulent years I have had and she has been my constant through it. I’m not going to go all borderline and say that I feel abandoned and rejected because I don’t. She has been brilliant in transferring my care over to SW London; I just hope they are as brilliant at picking up new referrals. Sure, there have been times where I have hated her and her actions. Where I have wished that she would give a little more support or take me a little more seriously, but I wasn’t really angry with her, I was angry with the system, with the NHS as a whole, with the lack of money and resources mental health gets within the NHS.

She wished me an easy Yom Kippur and we parted. Hopefully to never see each other again she said. I told her I had no plans to move back home in a hurry. She wished me good luck for the future and happiness with my new start. I got in my car and cried.

This is the start of a new chapter in my life.

Ruth

5 Ws And An H: Questioning My Existence

For anyone who is interested the 5 Ws and an H are as follows:

Who, what, where, when, why and how.

They seem to be all the prefixes to my questions now. Questions I have about my life, myself but most of all whether I deserve to be taking up a place on this Earth.

My life meanders on slowly, albeit with fits and starts. I have been in a job since the start of the academic term as a part-time lab technician back at my old school. I have finally started to move out of home and into the flat of my boyfriend (I’ve been with him a while – just haven’t mentioned him before). I’m also pressing assault charges against my Dad after I got caught in the crossfire and ended up in hospital overnight with quite bad injuries which are slowly healing.

As a result of this move in address, which will become formal at the end of the month I will have to move CMHTs and acquire a new CPN. Whilst this is not a huge issue in the fact that I will still see Dr Mc and Jane at the Priory, I would like to stop being supported by my Dad and break off all financial support from him. However, I realise that I will need to be referred to the NHS and receiving support from them before I can break off my relationship with the Priory. Also I am currently attending a bipolar group at the Priory which aims to focus on self-awareness of mood swings and triggers and combat relapses using a theory of medication compliance and CBT. It’s a bit wishy-washy at times but I think it is doing some good.

I witnessed a really bad road accident this afternoon. I was driving back from my brother’s house in Sussex and saw one car (silver) plunge into another car (red) at about 50mph. It was totally the red car driver’s fault, he tried to pull out across the incoming traffic when the silver car was approaching and misjudged the speed and distance but the fallout was massive. Red car completely crumpled and leaking diesel badly and silver car a write-off. Airbags in both cars had been deployed to the extent that the silver car’s windscreen was smashed with the impact of the airbag going off. The silver car’s driver had a badly broken knee from hitting the dashboard and bad contusions/lacerations to their head and the red car driver was unconscious at the scene with multiple injuries. The car behind me called the ambulance and as I was the only other person on scene at the time I put my, somewhat rusty, first aid skills into practice. Eventually the ambulances arrived, by this time red car’s driver had regained consciousness but was obviously seriously injured. The firecrews cut the red car driver out of the wreckage and he was blued into hospital whilst the rapid response paramedic dealt with the silver car’s driver. I gave a statement to the police and drove home.

I feel really bad about this but all the way home I kept wishing that I had been the driver of the red car. I don’t know how they are or what the lasting impact will be for them but I was jealous of them. Jealous for them being in a serious RTA which could have killed either of the people involved. Jealous for writing off their car.

I know I’m crazy, I have treatment for that – but how sick and twisted does that sound?

Ruth

Lies, Damned Lies: How I Keep Pretending Everything Is Alright

I don’t know why I do it, but I do. I have this unhealthy obsession with pretending to people that my life is trundling along with absolutely no problems and everything is fantastic when in actual fact it’s falling apart rapidly and being held in place by the tiniest of threads.

So many things are out of place at the moment. Life at home is harder than it has been in a long time and I simply do not know what to do about it anymore. The Met Police are at their wits end having to come out to the house most nights after being called by the neighbours. My Mum is not taking a blind bit of notice to anything that anyone tells her about the situation and I’m not sure what to do for the best. My Dad’s drinking has hit a record high; he managed to drink a litre of gin in 2 days along with copious bottles of wine. He won’t accept he’s an alcoholic and seems to find it amusing whenever anyone mentions the amount he consumes.

I have been attending A&E at the Chelsea & Westminster too often recently. I ended up there twice in less than 24 hours last weekend and saw the same junior doctor on both occasions; the second time he saw me he sutured the wounds without local anaesthetic. Allison is worried that because of this treatment I am now neglecting myself as I am refusing to go to A&E no matter how severe the damage is. She thinks I should write to the NHS trust but I can’t be bothered. The doctor would only lie and to be fair he’s done me a favour; I’m not going to A&E anymore so I’m not wasting their time.

I see Dr Mc for the first time in 4 weeks next week. I don’t think he’s going to be too impressed with what he sees.

Ruth

Tick Tock: How The Days Keep Going On By

I am surviving, and that is about all there is to it.

Survival.

Living each day.

Breathing.

Sleeping.

Eating (although much less of this one).

Trying to stay alive.

Ruth

Creature Comforts: Back Home In My Own Surroundings

I am finally back at home after pleading with Dr Mc that I was safe to be discharged today and didn’t need to be kept in over the weekend. I was going to be discharged earlier this week but after an overnight leave, and ignoring everyone’s advice about not driving whilst in this state, I drove my car and crashed it. Luckily I didn’t cause anyone or anything else any damage, as apparently my insurance is invalidated as I am driving whilst having a medical condition (mania) that I have not informed the DVLA about. If I do inform the DVLA, then my licence will be revoked and not reissued for eithe r3 or 6 months, depending on when I am stable, and then it will probably be assessed annually. Luckily no one has informed the DVLA, and as my car isn’t exactly in a good state at the moment, I won’t be driving for a while.

The valproate has been increased again, but although it has taken the top edge off my mood it hasn’t capped it like everyone had hoped it would. My thoughts are now racing around my head at about 200mph rather than 500mph, I can sit in a chair and only move my feet and hands, rather than jiggling my whole body around. It is little differences like that which have enabled me to be discharged though, so I guess I should be grateful.

This post isn’t going to make any sense, I can’t keep my thought process on writing it for long enough. I guess the basics are that I’m home, I’m now classed as hypomanic, I crashed my car, I self-harmed and ended up in A&E again on Saturday, I have made myself turn over a new leaf and be accepting and welcoming of the help the Priory are giving me as I do not know how much longer my parents can fund it, I see Allison on Monday and Dr Mc again on Tuesday and I only have to keep myself on the straight and narrow for the next couple of days.

Ruth

I Am What I Am: Accepting My Diagnosis

I saw Dr Mc on Friday and he concluded that I was in a hypomanic state that he was concerned would escalate into pure, unadulterated mania. I told him I was just happy for once and cheerful. He told me that happy people don’t sit for half an hour constantly moving around, fiddling with their rings/bracelet, staring out of the window and saying “oh look a plane” and talking so much that he couldn’t get a word in edgeways. He has decided to cut the dose of the reboxetine in half as he thinks the increased dose caused the mood swing and has added sodium valproate into the cocktail.

I didn’t start taking the valproate until last night. Mainly because all the research I could find on it told me it would cause an increased appetite and weight gain, something which regular readers will know I am battling with already. However, I spoke with a good friend online yesterday and told him that I had been prescribed it and what could he tell me about it (this friend knows about these sorts of things). He told me this (and I quote as I can remember not as a paraphrase) “it is the second in line mood stabiliser used for bipolar” after questioning he concluded that lithium was the first line drug used.

This made me realise that I am actually bipolar. Before I just thought people were saying it as they knew how I’d react if they told me I was borderline. In fact, saying that, I probably would react in a borderline way if they told me I had BPD, but then I still do have borderline traits. I have for so long, since I was officially diagnosed in the Priory at Christmas, fought against the diagnosis. I have claimed it to be wrong, that there is nothing wrong with me, that I may be on the bipolar spectrum but don’t fit the criteria for full blown Bipolar 1, in short I have used many, many excuses to try and escape the reality of the truth.

I don’t know why I was trying to escape the truth. After all, I’d rather have an accurate diagnosis than some wishy-washy guesses of what might, or might not, be wrong with me. I jsut never thought I had a ‘proper’ mental illness. Not one that you can put under the ’severe’ category when the professionals categorise them. I always just thought I was a bit crazy, lost touch with reality a few times, self-harmed, had issues with eating and was terminally depressed. My Mum however, as soon as she read the criteria for bipolar told me that was my diagnosis, and this was before I was admitted.

I saw Jane today and told her about my horrendous spending over the past 10 days or so. I recently opened a new bank account, which is the main one I am now using, forgetting that my old current account was in the red, to the tune of £500. Now I know I should have paid this off before Christmas, when I had money and decided not to be using that account anymore, but me being me I didn’t. Anyway, last night I got a phonecall from said bank requesting I repaid the overdraft back, in full. They gave me two options; pay by monthly installments (with an interest rate) or pay the amount in full. I opted to pay the amont in full. Very sensible you might all think, and I put it on my debit card, where I thought there was £500 or so pounds. It would take me to the wire, but I thought I’d still be in the black. Of course, my life being my life, paying off one overdraft has taken me into the overdraft of my current account, so I am officially penniless. This didn’t stop me spending money like nothing on Earth today though, I just used my credit card instead. One of these days I’ll learn, or hopefully the mood stabilisers will kick in before my credit rating falls through the floor.

We also spoke about my eating and drinking. I got totally and utterly trashed over the weekend with a couple of friends. I went out late on Friday night and was at least 30 sheets to the wind when I crashed out on my friend’s floor having rung the parents at some ungodly hour to assure them that I was still alive and not in the morgue. I then sheepishly went home on Saturday to be invited out again Saturday night, whereupon I got very drunk again, and did some very silly things, which I am not proud of and at the moments am not sure I wish to divulge into (mainly because I don’t want to accept they happened).

My drinking of other fluids is atrocious though and she is concerned that I am neglecting myself by not eating (this is a conscious effort to lose the blubber I have acquired) and not drinking enough fluids. I’m not deliberately becoming dehydrated, it’s just I am so busy with other things and busy with being busy that I forget to drink. I’m constantly on the go at the moment and remembering to have a glass of water is not a top priority.

She is going to contact my GP and Allison about the ’self-neglect’ which I am disputing is self-neglect at all. I see Allison on Friday and I doubt she is going to be overly joyed at Jane’s news, but then she doesn’t seem overly joyed with anything I do at present. I see Dr Mc again on Friday as well, hopefully I can try and keep a lid on things this time and be a little less bouncy so he doesn’t think I’m hypomanic/manic. I am still trying to get put back on venlafaxine, but it’s not having much effect. I think maybe I’ll try appealing to his better nature this time (if he has one) rather than being ‘lippy’ (his words about how I was in the appointment) like I was last time.

Ruth

Round In Circles: I Can’t Get A Straight Answer

I saw Allison yesterday and I was in a very irritable yet agitated mood. It was lucky that we sat in the interview room as it has no windows I could stare out of, unlike when I saw my therapist and I was like “oh look, a plane” about every 5 minutes. Instead I just sat fiddling with my rings and twisting my foot round and round. She gave me a pen to fill in some stuff and a couldn’t stop clicking it. I’m wondering if I am on the way up, after all it is a week since I started taking the anti-depressants again (at the recommended higher dose) and the only anti-depressant that doesn’t send me sky-high when the dose is increased is venlafaxine. Unfortunately, despite the claim of weight loss as a side effect of reboxetine, I am not one of the ‘common people’ it affects. God damn it.

Allison and I talked about the case review at the GP’s surgery and how she became involved. She apparently is still worried about me as I still pose a high suicide risk. In fact, that reminds me that she still hasn’t given me my dressing gown cord back when she said she would in the following appointment from when she took it off me, and it must be over a month that she’s had it now. We spoke about the cancer and how I realise that I have no effect on the course it will take. I pointed out to her that although I haven’t been compliant with my mental health treatment I have been consistently compliant with the cancer treatment; going for chemo, radiotherapy, attending appointments etc. I am doing as much as I can to recover and to get into remission but unfortuantely it is an illness that will take it’s own course and no one can prevent it from doing what it feels like. It is curable and they can try and halt the spread, but ultimately it has the upper hand.

When I said this to her she looked shocked and asked if I had realised that it could kill me, and what my thoughts on that were. I explained the above to her and said it was miles apart from mental health where you can take some responsibility for your recovery in engaging with talking therapies and exercising etc. She said that I was taking an ostrich approach to it (i.e. sticking my head in the sand) and this is why there was a case review about me. Apparently I am a suicide/self-harm risk (which I proved by ending up in A&E just the other day), I am not necessarily entirely stable in my moods yet (could be because I have only just re-started taking the tablets – a fact she is aware of) and I am being flippant when it comes to serious matters.

I told her, in no uncertain terms, that they didn’t seem reasonable enough excuses to hold a meeting behind my back which I only found out about with a call from the crisis team (and every person in that room at that time knew my view on involving the crisis team in my life) and not being able to pick up a repeat prescription, whereupon I couldn’t get an answer out of my GP.

I also asked why the idea of consulting Dr Mc before my appointment was not mentioned to me earlier as I had a right to put my case forward before I have to see him in person (this afternoon). Yet again, she couldn’t think of a reasonable answer. I felt like I was going round in circles, trying to get a straight answer and being fobbed off with the same crap that everyone has been mentioning in a risk assessment since I was discharged in February.

I am still quite angry, yet can sort of see their viewpoint of me being a danger to myself and because I span the NHS and the private sector it is often difficult for the two to communicate (despite the advent of emails and fax machines they still are in their 2 little boxes and inevitably I act as the go-between telling my GP and Allison what Jane and Dr Mc have been suggesting/doing and vice versa).

I have to see Dr Mc this afternoon and I can feel myself going quite high. The hallucinations are back despite being on an anti-psychotic and I know he will suggest a different mood stabiliser. I am quite happy with the lamotrigine, the medication I want changing desperately in the reboxetine in favour of venlafaxine. Not because it is a better anti-depressant, although in some ways it is as it stopped the complete mood swings (it just left me in a complete depressed state, although I hasten to add that the suicide attempts took place whilst I was on duloxetine), but because when I was on it I weighed at least 2 stone less.

No matter what I try, staving myself, eating healthily, purging food after I have eaten it, taking as much exercise as I can (difficult with a leg that is just out of plaster and lungs that mean I get breathless easily) I cannot shift this weight. I cannot buy the OTC drug Alli (orlistat) because I have lost a little weight and my BMI isn’t 28 or above. I have toyed with the idea of amphetamine based diet pills, or ones that contain caffeine/guarana but then last time I ingested a lot of caffeine I went totally manic.I want venlafaxine and I want it now. I found an old prescription for it in my drawer but unfortunately it is nearly a year old so they won’t dispense anything from it now. I know it sounds like I am being petty but my weight means a lot to me and at the moment it is constantly praying on my mind, every second or every day.

I guess I just have to wait and see what Dr Mc says this afternoon. I bet he says that he wants to give the reboxetine a bit more of a chance to kick in and that the mood stabiliser needs reviewing. In fact if I was a monetary gambling girl then I would put money on it.

Ruth