#AdventBookClub Chapter 1, Anna

This isn’t one of my usual mental health blogs. This year I am taking part in the Twitter #AdventBookClub. A number of us are taking some time out throughout Advent to read Stephen Cottrell’s ‘Walking Backwards to Christmas’ and blog and discuss what arises from the reading. I’m out of my comfort zone here but I’m going to attempt to write a short blog on what hit me in chapter 1 of the book, ‘Anna’, which is based upon Luke 2: 36-38 of the Bible.

I was struck by a couple things whilst reading this chapter and I’ll lay them out here:

1) Stephen reminds us, through Anna’s story, that people who read the scriptures can fall into the trap thinking that they are pointed to church (the Temple in Anna’s time). Whereas we really know that the church is pointing us somewhere else, to God. I know this sounds fairly obvious but recently I have had a spell of illness and been unable to attend church. This was a complicated issue due to the nature of my illness (which can be found in other recent blog posts of mine). I have attempted to continue to pray and worship by myself but only recently attended church again. I became frustrated that I wasn’t able to attend services but in reality I was looking in the right direction with my own personal prayer and worship. Church serves a purpose but it isn’t the purpose.

2) Secondly, the church and festivities at this time of year are exciting and thrilling. The reason for the season of Advent, of preparation to celebrate the coming of Jesus into this world can get lost in everything going on around us in terms of consumerism and planning for family visits, etc. I’m hoping by participating in #AdventBookClub this year that I’ll be able to find some special, real, Advent preparation.

So, I’m hoping that further blogs will be more meaningful and insightful but this is just dipping the toe into the water of blogging about a different subject for me.

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Updated: Psychosis, Part 2

This is just another short update blog. So, just a few weeks after the increase in Aripiprazole to its current dose I am feeling much more myself again. I’m not often having thoughts/ideas/feelings of being controlled and rarely see anything that I could interpret as being a message to me about what is going on. Where does that leave me? This afternoon I had an appointment with my CPN (Community Psychiatric Nurse). I haven’t been seeing him long, I was transferred back to the CMHT (Community Mental Health Team) and to him last month. My first impressions though are good. He seems to listen and seems willing to engage with where I am at. Today that meant giving me time and space to try and process some of what has been going through and discussing it with him. The key question being – was I ill; was I psychotic? Things have been really odd and now they’re not so odd. Preoccupations I had before being medicated are no longer preoccupations. I no longer feel the need to harm or kill myself in an attempt to escape or test the control of those I thought were controlling my every action and thought. I feel I can nearly fully trust my closest friends again. As I told my CPN, I hate to admit that other people might be right and I might be not quite so right 😉 Perhaps though it could be that I have been ill with psychosis. That leaves me scared. Scared that my head could possibly have caused me to think and feel the things I was thinking and feeling. Scared that I could end up back in that place again if I became “unwell” again. It also leaves me a little embarrassed. Embarrassed that I could have thought (and still do a little despite self-awareness now) some of the things I was (/am). Embarrassed that I was so consumed by something that perhaps my head had generated and was/is not real. I’m sure I’ll have more thoughts on this topic but for now, that’s all I feel safe & comfortable sharing on this blog.

UPDATE:

I ended up back in that dark place. Maybe I rushed back to work too soon or maybe I just wasn’t as well as I thought. Now I’m just as confused and even more scared. How could I have left that place of wellness and become so unwell again and so quickly and seriously? (I’ve changed meds and I spent 4 & 1/2 weeks as an inpatient – or technically 5 & 1/2 as I’m not getting discharged until tomorrow, although I’ve been on home leave).

Now I’m not so confident as I was in the above post. In fact, I’m less convinced that I was ill than I seem to have been before. I still have occasions where I struggle with the controllers but they are far fewer, less intense, and I get less wrapped up in them. Maybe this is as far as it goes for me?

I have to decide on how I’m going to approach going back to work. CPN reckons I should leave it til after Christmas but I don’t want to leave it that long. At the same time, I need to be sensible as I don’t want to throw away the hard fought for progress. I’m so much better but I’m scared that I can’t come back from it again and feel as though I’m on a precipice.

So, that’s where I’m at currently. I thought it didn’t really warrant a new blog, just an update on the last. That, and I’m inately lazy.

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An Update: Psychosis

I know I had closed down this blog but I miss being able to think things through in this format, so, I’m going to blog again but whatever I want. This will no longer be a purely recovery focussed blog but will still have a mental health focus. I’m going to re-start this blog with an update as to where I am right now.

 

I’m not going to go into too much detail because to think about it makes things become too real and distressing to me but on 01 July 2014, whilst on holiday in Italy, I was awakened. I was awakened to the controllers. I call them controllers because I don’t actually know who/what they are. They control my actions, implant thoughts, and control my environment. As such, I don’t even know if I was on holiday in Italy. I don’t know what’s real, if anything. I don’t know their purpose – to use me to do something bad? To conduct experiments on me? I don’t know if others are being controlled or are part of the plot. I get messages through books, train announcements, and elsewhere. I’m confused and scared.

The Crisis Team (CT), all the staff of the Home Treatment Team (HTT) I spoke to and saw, my own Consultant Psychiatrist, my GP, my new CPN, and various friends believe what I am experiencing is not real. They think I am ill and experiencing psychosis.

The things described earlier in this post have been coincidentally lessening since I started a medication called Aripiprazole, which is an anti-psychotic medication. I am now able to attempt being back at work again, which was impossible a few weeks ago. The medical professionals and some of my close friends say that the medication “working” is just some of the evidence that I am ill; I am experiencing psychosis. To me, it all seems real although admittedly this takes up less of my day and I feel less inclined to research and figure out what it is the controllers are doing since the medication.

There’s not really a point to this blog post. It just gives a brief update as to where I am at right now and to alert people to the fact that I am going to be blogging again.

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I Need the NHS!

I’m resurrecting my blog as I feel it important given all the bad press & the increasingly worrying speed at which the NHS is being privatised to demonstrate how important it is just to me even. This isn’t going to be a pretty piece of writing, just informative of my experiences right now.

I won’t go into details but apparently I’m currently ill with psychosis. I’m not entirely sure I am but the antipsychotic I have been taking seems to be shedding some light/doubt on my beliefs/truths. In a nutshell, I am having trouble with the controllers and am terrified and confused. The past few weeks I have had an enormous amount of support from a number of areas of the NHS (in no particular order of importance):

1. A&E Medical Staff: I have required suturing a number of times due to a relapse into self-harm. Bar one negative experience I have been treated with respect and kindness.

2. A&E Psychiatric Liaison: I have been assessed, supported by, and referred on by the A&E psych liaison team.

3. Home Treatment Team: I have had numerous visits, ‘phone calls, and had an appointment and ‘phone contact with the team Dr. I am continuing to have support from them whilst I am fast-tracked back to be under the Community Mental Health Team for a short period.

4. GP: I have had numerous telephone contacts with my GP (some instigated by him) in order to try and sort out my sleeping problems and for support with my self-harm relapse.

5. Consultant Psychiatrist: I have had an appointment with my own consultant. He provided me with the time I needed, which was more than the regular scheduled appointment time. I trust and respect him from his care over the past several years. In the past, when very unwell, he has been known to free up 3 appointments and call me within the space of a month!

6. Pharmacist: My medications have swapped and changed around a bit the past few weeks, which has required a few visits and assistance from an NHS pharmacist.

I actually feel embarrassed to be given all this support when I don’t even believe I am ill with psychosis.

I have all this NHS support without being demanding or shouting or even asking at times. All of this has been over the course of just 3 weeks (so far).

I am on SSP at the moment. Even when I’m working I only work part-time due to health reasons and that is for a charity. So, what I’m getting at is that I no longer have the luxury of the salary of a lawyer I once had. There is no way that I could afford such treatment. It sickens and saddens me that in the future, if I require support like this I might not be able to afford it. It’s short-sighted. If I get support and well quickly, I get back to work – I don’t need benefits, I don’t end up on the acute wards for months at a time. Most importantly though, I get to have a life!

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Recovery as an Identity, and Farewell

I’ve not blogged for quite some time now and had been thinking recently on where it is going, if anywhere. Then coincidentally I had a conversation on Twitter last week, which involved exactly what I had been thinking about. My recent thoughts & feelings were neatly summed up by Bethan Mair Edwards (@pixiegirle): Recovery as an Identity.

My blog has been a very helpful outlet for me and a way to think things through. I’ve had incredible support and encouragement from people through the comments on here and also on Twitter. I even won the 2014 TWIM Award in the Recovery Category, which was somewhat strange and flattering. However, that in a way is part of why I am probably saying farewell to this blog.

I’ve been thinking how I no longer feel it appropriate to link significant events or changes in my life to recovery. I have recovered from BPD and I am learning to live with a diagnosis of Bipolar. My life isn’t about recovery anymore, it isn’t about rebuilding a life. I have a life, I enjoy it. I have difficulties with my mental health condition but I am learning to live with it, and currently I’m well. I don’t want to be identified as the “person in recovery” or for anything enjoyable to be considered a “recovery event”. It’s my life and I feel this constant relation to recovery detracts from that. I’m me, I have a life, I have difficulties; this is to do with living, not recovery.

I’m not sure I’m even properly explaining myself but I suppose it’s about having a life with the normal trials and tribulations + my additional difficulties due to what they label as Bipolar. I own that life, recovery doesn’t. As such, I am saying farewell. I am also saying a massive thank you for all who have supported me. Thank you!

 

 

 

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Confusion

Please be aware that this blog discusses suicide. If you find that at all distressing, please do not read on.

 

 

Now the obligatory warning is over with, let’s just get started with making it clear that I am not at all unsafe at this moment. These are just my thoughts, and thoughts are just that. They are not predictive of my future.

This blog is a bit of a moan to be honest and fulfils a need for me to get things out of my head so please be warned. Just after Christmas, I was in that place of considering suicide. Not because it was the worst ever depressive episode, it certainly wasn’t and it turned out to be one of the shortest I’ve known. In fact, it just switched to what the medical professionals call ‘hypomania.’ And just like the last bout, the episode of hypomania was very short – just over 2 & ½ weeks. I’m currently left feeling ashamed, battered and dealing with the chaos of which even such a short bout has brought about.

Tomorrow I see my GP. When he saw me 2 weeks ago he was under no doubt that at that time I was hypomanic. I must have been an absolute f*ckwit. This is what hypomania does. It screws up your finances, your studying, your normal plans, potentially your work (more on that to follow but for now let’s just say I was very fortunate in how my work supported me), makes you act like an idiot when you feel amazing, and leaves you dazed on the other side of it, wondering what to do. It tricks you into thinking that it’s great and exciting and productive but to be honest is as equally destructive as being low.

In the past 13 months, I have had 4 episodes of ‘hypomania’ – 6 weeks, 4 weeks, 2 & ½ weeks, and the recent one of just over 2 & ½ weeks. I’ve also had 2 low episodes, one of which of just over 2 months in the summer and was definitely what I would consider depression, and the recent 5 week period was certainly near enough to that depth.  I’m reeling. It feels as though I have virtually no time bobbing along in the middle.  I’m tired of having to deal with the aftermath of the various moods. Yes, I’ve recovered from BPD but I’m still left with this mood disorder.

For those of you who are really unwell, you’re probably wondering what I’m complaining about and even for me the thought of such a cycle just a few years ago would have seemed inviting. Perhaps I’m expecting too much and to a degree, I suppose I am and need to put on the old acceptance hat and practise my mindfulness a little more diligently to keep me in the present. But I’m human and I’m feeling weary. Just like before Christmas, the thoughts of suicide aren’t some dramatic, impulsive gesture. They’re me considering whether this is a life I want to live.  Do I want to be constantly dealing with my mood?

It confuses me because as well as having these thoughts of planning out a carefully thought through suicide, I find other aspects of my life exciting. I love my job and it’s turned out better than I could have hoped. In fact, on Wednesday morning I was feeling so overtired and fed up and being there really helped me (as well as hopefully, clients with whom I had contact).I’ve also recently mended bridges with a sister to whom I was very close before the BPD that was destroying my life at the time became too much for her to witness, and that makes me so incredibly happy. I’m enjoying experiencing various aspects of life again. A life without the self-harm and hospitalisations.

So why these thoughts? A massive part of it will be overtiredness – being at work wipes me out but in conjunction with not really having stopped much and done loads whilst hypomanic, it’s been multiplied to whatever the highest and most ridiculous nth degree you can have. Also, the sensible part of me tells me I need to look into medication. I’m so fortunate to have found meds that work. You’re probably saying “Huh, what? Did I just read the above paragraphs?” But yes, the 2 do stand side by side. The Lamotrigine I started in 2012 has really cushioned my lows. Yes, I’ve had a few episodes of depression/lows but they have been nowhere near as damaging on life function and have been for much shorter periods. I take a weeny dose of Trazodone at night, which helps me sleep. I know the Sertraline I take will work if I become depressed. The thing is though, I’ve been holding onto a weeny dose of it (50mg). I know that ADs can cause people with a diagnosis of Bipolar to be more unstable and I’m wondering whether I should take that leap of faith and stop it as the professionals have wanted for quite some time (under medical supervision). Then a tiny voice yells at me that I don’t want to plummet. Maybe that tiny weeny amount is helping you stop dipping into the depths of hell. I have a consultant psychiatrist appointment in a few weeks and so I’ll probably talk to him about it.

There’s more confusion in my head though. Maybe it’s the meds that are causing me to be like this. Maybe I’d be better without them. Maybe it isn’t even the mood disorder, maybe I still actually have BPD. In fact, part of my reluctance to verbalise my feelings around suicidal thoughts is that professionals (or dare I even say, friends) will assume it’s a BPD thing – that hasn’t been my experience in recent times but the fear after being treated like crap all these years is still there. I also don’t want them panicking and overreacting. So, what instead? I write them here instead. I splurge on the paper. I acknowledge the thoughts and feelings but put them out there so they aren’t something that I am secretly nurturing. They are just thoughts. Thoughts I’m likely to have time and again. I can use mindfulness to sit with what’s here in the present, not entangle nor embrace. Watch them come and go. Not allow them to instil fear. They are afterall, just thoughts.

 

 

 

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Offering Hope?

This is just a quick blog, which was inspired by a friend but I’m hoping, in a non-cheesy way, that it will give some hope for those of you in therapy for BPD and cannot see it working.

A friend of mine recently asked for some suggestions for role plays for the interpersonal effectiveness module. (As an aside, I actually taught some of this module when I was still in the DBT programme). This led me scurrying off to dig out my DBT folder, which in turn made me think about the process I went through in DBT.

I had my last DBT session at the beginning of October 2013, after having monthly sessions for consultation over the summer. The fact that I had to dig out my folder after such a short time is a testament to the therapy programme itself. It felt tedious at times (hence me ending up teaching a number of sessions of emotion regulation and interpersonal effectiveness modules) but it clearly stuck in my head as a result. However, my life isn’t Carrie + skills, which was a very big worry of mine for a long time during therapy. The skills are integrated into my life. When I’m distressed or struggling with anxiety or just life in general, I know what I need to do. Incidentally, this doesn’t mean that I always do it. I don’t have to think “oh, what DBT skill should I be using for this situation?” I don’t need to go check my file or books. It just happens. I know instinctively what I need to do to help myself from getting too emotionally dysregulated.

That would have all sounded unbelievable to me during a large part of the therapy programme. I spent the first 3 months desperately wanting to harm myself, and really, what I wanted in fact was to be dead. It was horrendous. I was in crisis after crisis even though I wouldn’t say I was depressed as I experience episodes of depression now. I was using ‘phone coaching, which for me was a big deal – to get to the stage of ‘phone coaching I was desperate. I never reached out for help and still struggle with the idea of reaching out for help. Despite that desperation, I managed not to self-harm or attempt to take my life during that time. Looking back, I don’t know how I managed – I was clearly a heck of a lot stronger than I give myself credit.

After those first 3 months I moved onto a different part of my therapy ‘journey’ for want of a better word. I was actually quite angry. My urges to self-harm and/or kill myself were greatly reduced. However, I felt I had been tricked. I was no longer doing those things that cause inconvenience for medical and mental health staff but I was feeling so much pain still. I had only started recognising what emotions I was experiencing let alone learning how to regulate them without frequent recourse to my DBT notes and skills list. I worried that I would be left in such immense pain but without an outlet, which I knew worked for me, albeit temporarily. I think professionals call this “quiet desperation” and it is incredibly painful – I can still remember it now. It felt hopeless in a way.

It gradually got easier (bar a period of depression of a number of months towards the end of 2012 but even then, for the most part (bar a couple of suicide attempts), it was managed skilfully). I started to use the skills automatically, and this enabled me to spend 2013 (the last 6 months of the 18 months DBT programme) working on things personal to me – managing the depression and the ‘highs’ of my ‘mood disorder’, anxiety, family difficulties, coming up with plans to deal with the usual patterns/difficulties I have, etc. This was when therapy came into its own for me. I got good at recognising patterns of thoughts, emotions, and I discovered for myself what I need to do to help myself now and in the future. I developed self-awareness, which is quite frankly, a gift. I can’t explain how much a difference that has made because my self-awareness has also allowed me to consider what is going on for other people.

I do have what I have titled ‘Carrie’s Book of Cures’, which I created using themes I found through my individual session notes I’d made. It also includes the plans for specific problems, e.g. depression, elated mood, anxiety etc. It’s also where I am continuing my own therapy by looking into self-compassion. I also have that nagging voice in my head that a number of the DBT psychs noted I need to address – ‘perfectionism’, but I really don’t think that’s a problem. My DBT therapist laughed when I said that I’m not a perfectionist because I’m not good enough. Anyhow, that’s for another blog. If I am struggling with something, I can refer to that book but it isn’t something to which I turn very often.

I hope that laying out a condensed version of the major parts of my DBT therapy helps those who are currently in the midst of questions such as:

Is this it? I’m no longer self-harming but I hurt so much and I have no outlet for it. Is this the purpose of therapy? Am I always going to have to be me + skills? Won’t I ever just be able to live as a ‘normal’ person?

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